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34 Cards in this Set
- Front
- Back
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Viscus?
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One internal organ
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Visceral?
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Pertaining to any internal organ
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Where does the referred(visceral) pain go to?
-Foregut -Midgut -Hindgut |
Foregut-Epigastric
Midgut-periumbilical Hindgut-Suprapubic |
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VISCERAL ABDOMINAL PAIN
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PRIMARILY MEDIATED BY AFFERENT C FIBERS LOCATED IN WALLS OF HOLLOW VISCERA AND CAPSULES OF SOLID VISCERA
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Where is viscera abdominal pain preceived?
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PERCIEVED AS MIDLINE DUE TO BILATERAL SENSORY SUPPLY
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SOMATIC (PARIETAL) PAIN
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ARISES IN ABDOMINAL WALL ESP. PARIETAL PERITONEUM
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Where is somatic pain preceived?
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CONVENTIONALLY DESCRIBED AS OCCURING IN ONE OF THE 4 ABDOMINAL QUADRANTS, EPIGASTRIUM OR CENTRAL AREA
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Describe somatic pain?
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localized and sharp
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subdiaphragm area referred pain
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- IPSILATERAL SHOULDER
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BILIARY TRACT Referred Pain
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- RIGHT SCAPULA
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PANCREAS Referred pain
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Lower thoracic area
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Uterus and rectum referred pain?
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Dorsal midline sacrum
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describe visceral pain?
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Dull, vague, midline
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What is the sequence of how someone with acute appendicitis will present?
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Pain, (Vomiting and/or diarrhea), Tenderness, Fever and Leukocytosis
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vomiting before the onset of pain is ____ and should raise suspicion of different diagnosis
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Rare
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Psoas test:
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PATIENT LIES LEFT SIDE DOWN WHILE EXAMINER PASSIVELY EXTENDS THE RIGHT LEG TO STRETCH THE PSOAS MUSCLE
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Psoas Test + test usually means that a patient has a
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Retrocecal Appendix
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Obtruator Test:
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Patient lies supine, flexed at the knee and the doctor internally roatates their hip
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Obtruator + Test usually means the paitent has an inflammed ?
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Pelvic Appendix
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Rovsing Sign?
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LEFT LOWER QUADRANT PALPATION INDUCES RIGHT LOWER QUADRANT PAIN
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What kind of fever and Increased WBC would you expect in someone with acute appendicitis?
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A fever no greater than 1C and a slight Neutophil increase (WBC=10,000-15,000)
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Imaging Technique of choice for appendicitis?
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CT scan
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McBurney's Point
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1/3 from ASIS to navel
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If the oen goes in for a appendectomy but when the surgeon gets in the appendix is not swollen what should he do?
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Look for other pathologies while still removing the appendix
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Radiation to right scapula or shoulder
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CHOLECYSTITIS
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What is the imaging technique of choice in cholecytitis ?
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Ultrasound
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EPIGASTRIC ABDOMINAL PAIN, CONSTANT, CAN BE SEVERE, RADIATES TO RUQ & BACK
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pancreatitis
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left-sided appendicitis”
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diverticulitis
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What is the imaging technique of choice for divertiulitis?
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CT scan
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history of recurrent epigastric pain, esp. on empty stomach,relieved by eating
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Peptic Ulcer
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History presents as:
Sudden onset of severe epigastric pain Patient recalls exact moment when pain began |
Perforated peptic ulcer
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Physical Presents as:
Patient appears acutely ill in severe distress but laying quietly afraid to move Diffuse, severe abdominal tenderness |
Peforated Peptic Ulcer
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Plain, upright abdominal X-ray will usually reveal “free air”
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Perforated Peptic Ulcer
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“Pain out of proportion to physical findings”
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Mesenteric Ischemia
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