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48 Cards in this Set
- Front
- Back
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What causes mid-epigastric pain that radiates to the back?
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Pancreatitis.
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Where does pain from the gall bladder radiate to?
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From the RUQ to the shoulder blade.
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What type of GI pain is often retrosternal?
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Esophageal.
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Small intestine pain will radiate to what part of the abdominal wall?
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Periumbilical.
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Nausea, low grade temp, and periumbilical pain that goes away and then comes back at McBurney's point is indicative of what?
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appedicitis.
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What is the big tip off for gastric or duodenal pain?
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Gastric causes are relieved by fasting, duodenal by eating.
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Ureteral pain will radiate to what area?
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The groin, or suprapubic area.
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What is the big tip off for gastric or duodenal pain?
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Gastric causes are relieved by fasting, duodenal by eating.
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Ureteral pain will radiate to what area?
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The groin, or suprapubic area.
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What are the signs of acute abdomen?
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Abdominal distention with tympani on percussion
Tenderness to palpation Rebound tenderness Increased or DECREASED bowel sounds Cutaneous hypersensitivity Pain with coughing May have diffuse rigidity of abdominal wall |
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What's the difference in the abdominal exam order from heart and lung exam order?
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Auscultation comes before percussion.
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What are 6 F's of a distended abdominal?
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Fat
Fluid (ascites) Flatus Fetus Feces Fatal growths (tumors) |
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What does Gray Turner's sign indicate?
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A variety conditions associated with retroperitoneal and intraperitoneal bleeding, incuding pancreatitis, and ovarian cyst hemorrhage, etc.
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What are the five major mechanisms that produce abdominal pain?
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Stretching of encapsulated organs
Irritation of Mucosal Lining Smooth muscle spasm Peritoneal irritation Direct splanchnic nerve stimulation |
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A patient comes to you with moderate, but constant abdominal pain in the RUQ. What is a likely diagnosis?
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Liver congestion secondary to CHF
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A patient presents to you with a burning pain in the LUQ. What is your differential?
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Irritation of the mucosal lining of the stomach or the duodenum.
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A patient comes to you with uncontrollable diarrhea and crampy abdominal pain. What is a likely diagnosis?
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IBS or viral gastroenteritis
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A patient comes to you complaining of RLQ pain. Upon examination, the patient is in obvious discomfort when you gently palpate the area. The patient describes the pain as knife-like. What is your differential?
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Appendicitis, diverticulitis, and less likely, cholecystitis
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A patient presents to you with diffuse abdominal pain. She rates her pain on at a level of 6, on a scale of 10. When asked to point to the pain, she says that there isn't a single spot. What is likely happening on a neurological level?
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Her splanchnic nerve is being compressed, perhaps by pancreatic cancer or an expanding aortic aneurysm.
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A man comes to you complaining of testicular pain. He has also noticed blood in his urine for the past 2 days. What's the differential.
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Renal calculus (and I don't know what else)
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Epigastric pain that radiates to the left shoulder is indicative of what?
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Gastric problems.
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A differential for a patient complaining of front to back abdominal pain includes what?
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Acute pancreatitis
ruptured abdominal aortic aneurysm Posterior duodenal ulcer Retrocecal appendicitis |
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An umbilicus displaced downward by 2 cm or more indicates what condition?
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hepatomegaly
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Grey-Turner's sign allows a differential of what complications?
(ecchymosis in the flanks) |
Pancreatitis
Ovarian cyst hemorrhage Bilateral salpingitis Strangulated bowel w hemorrhage |
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Cullen's sign allows what differential?
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Retro or Intraperitoneal bleeding
Blood travels thru falciform ligament to the periumbilical area. |
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What happens to abdominal venous flow in an inferior venal caval obstruction?
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The flow is reversed from downward (caudad) below the umbilicus, to an upward direction.
Collaterals prominent in flanks. |
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What does caput medusa indicate?
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Cirrhosis of the liver: intrahepatic portal vein obstruction
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Grey-Turner's sign allows a differential of what complications?
(ecchymosis in the flanks) |
Pancreatitis
Ovarian cyst hemorrhage Bilateral salpingitis Strangulated bowel w hemorrhage |
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Cullen's sign allows what differential?
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Retro or Intraperitoneal bleeding
Blood travels thru falciform ligament to the periumbilical area. |
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What happens to abdominal venous flow in an inferior venal caval obstruction?
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The flow is reversed from downward (caudad) below the umbilicus, to an upward direction.
Collaterals prominent in flanks. |
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What does caput medusa indicate?
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Cirrhosis of the liver: intrahepatic portal vein obstruction
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When herniated tissue twists and occludes vaculature, this is known as what? (in the small bowel)
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Strangulated bowel
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What is the most common type of hernias?
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Incisional hernias
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Where does the spigelian hernia show up?
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3-5 cm above the inguinal ligaments
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What are the 2 types of intestinal ileus?
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paralytic ileus
mechanical ileus |
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WHen is paralytic ileus very common?
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After an abdominal surgery
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What are some of the causes of adynamic (paralytic) ileus?
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post op abdominal surgery
peritoneal irritation electrolyte disturbances (i.e. low potassium) narcotic medications intestinal ischemia |
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You see a patient X-ray showing air in the small bowel, colon, and rectus. What does this indicate?
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adynamic ileus
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What are possible causes of mechanical SBO?
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adhesions
hernia (strangulated) volvulus gallstone ileus intussucepion |
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What are some of the causes of LBO?
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tumor
volvulus (in sigmoid region, commonly) hernia diverticulitis (although more often leads to adynamic ileus) intussuception |
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Upon auscultation of a recent bowel obstruction, what sounds might be expected?
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Increased bowel sounds (borborygymi)
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Upon auscultation of long-existing bowel obstruction, what kind of bowel sounds might be expected?
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decreased bowel sounds and high-pitched tinkles
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On light palpation, a mass becomes more prominent when a supine patient raises their head. What does this indicate?
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In intramural mass.
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Involuntary rigidity of the abdominal wall is a good indicator of what condition?
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peritonitis
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Involuntary guarding is a pretty good indicator of what condition?
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peritonitis
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Indirect tenderness indicates inflammation a site distant from the area of palpation and is a sign of what?
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peritonitis
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What is Murphy's sign
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Sudden cessation of inspiratory effort when physician palpates along bottom of ribcage
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Courvoisier's sign?
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palpable gallbladder and jaundice = LR 26 for extrahepatic obstruction.
Could be cancer or a gallstone |
