Opp - Gi And Gu

Front 1

To what does the spleen lie anterior?

Back 1

ribs 8-10

Front 2

To what does the spleen lie posterior?

Back 2

large intestine at transverse-descending transition

Front 3

Pain distribution: substernal

Back 3

esophagus

Front 4

Pain distribution: RUQ

Back 4

duodenum, liver, gallbladder, colon

Front 5

Pain distribution: mid-epigastric

Back 5

stomach

Front 6

Pain distribution: generalized upper abd

Back 6

pancreas

Front 7

Pain distribution: peri-umbilical

Back 7

small intestine

Front 8

Sympathetic IV: esophagus

Back 8

T2-8

Front 9

Sympathetic IV: upper GI

Back 9

T5-9

Front 10

What does "upper GI" include?

Back 10

stomach, liver, gallbladder, spleen, pancreas, duodenum

Front 11

Sympathetic IV: middle GI

Back 11

T10-11

Front 12

What does "middle GI" include?

Back 12

pancreas, duodenum, jejunum, ileum, R colon

Front 13

Sympathetic IV: lower GI

Back 13

T12-L2

Front 14

What does "lower GI" include?

Back 14

L colon, rectum, pelvic organs

Front 15

Greater splanchnic nerve distribution and place of synapse

Back 15

T5-9; celiac ganglion

Front 16

lesser splanchnic nerve distribution and place of synapse

Back 16

T10-11; SMA

Front 17

Least splanchnic nerve distribution and place of synapse

Back 17

T12-L2; IMA

Front 18

What does sympathetic IV cause?

Back 18

increased vascular tone; decreased O2 and nutrient delivery; decreased peristalsis; relaxation of gallbladder and ducts; contraction of rectal sphincter; splenic vasoconstriction; decreased mucosal defenses in stomach

Front 19

Common complaints of someone with hypersympathetics:

Back 19

constipation, abd pain, flatulence, distention

Front 20

Parasympathetic IV: lower 2/3 esophagus

Back 20

vagus nerve

Front 21

Parasympathetic IV: L vagus nerve

Back 21

greater curve of stomach, pyloric sphincter

Front 22

Parasympathetic IV: R vagus nerve

Back 22

upper GI, liver, gallbladder, R half of colon

Front 23

Parasympathetic IV: pelvic splanchnic nerves (S2-4)

Back 23

L colon and pelvis

Front 24

What does parasympathetic IV cause?

Back 24

increased acid and mucous secretion, contraction of gallbladder and ducts, peristalsis

Front 25

Common complaints of someone with increased parasympathetics:

Back 25

N/V, diarrhea, hyper-motilitiy related cramping and pain

Front 26

Viscerosomatic reflex for: esophagus

Back 26

T3 on R

Front 27

Viscerosomatic reflex for: stomach

Back 27

T5-8 on L

Front 28

Viscerosomatic reflex for: iliocecal area

Back 28

R iliotibial band prox to femur head

Front 29

Viscerosomatic reflex for: ascending colon

Back 29

R IT band, middle part

Front 30

Viscerosomatic reflex for: R 2/5th of transverse colon

Back 30

R IT band, prox to knee

Front 31

Viscerosomatic reflex for: sigmoid area

Back 31

L IT band, prox to femur head

Front 32

Viscerosomatic reflex for: descending colon

Back 32

L2-3 on L, L IT band, middle part

Front 33

Viscerosomatic reflex for: splenic flexure

Back 33

L IT band, lower middle

Front 34

Viscerosomatic reflex for: L 3/5ths of transverse colon

Back 34

L IT band, prox to knee

Front 35

Pain distribution for pancreatitis:

Back 35

epigastric pain with radiation to back

Front 36

Dx: pain gets better with leaning forward

Back 36

pancreatitis

Front 37

Dx: vomiting, low grade fever, jaundice, decreased BS, Grey Turner and Cullen signs, hypotension

Back 37

pancreatitis

Front 38

Ranson's criteria for pancreatitis on admission

Back 38

> 55 yo, WBC > 16K, serum LDH > 350, BG > 200, SGOT > 250

Front 39

Ranson's criteria for pancreatitis after initial 48 hr

Back 39

Hct decreased > 10%, BUN increased > 5, Ca < 8, art pO2 < 60, base deficit > 4, fluid sequestered > 6L

Front 40

Tx for pancreatitis:

Back 40

psoas tenderpoint, thoracic diaphragm, thoracic/lumbar/iliosacral mobilization, OA decompression

Front 41

Pancreas lymph drainage

Back 41

celiac nodes

Front 42

Why do you have increased psoas usage with pancreatitis?

Back 42

abdominal muscles become weakened

Front 43

Pain distribution for PUD

Back 43

epigastric pain with radiation to back

Front 44

What makes PUD pain better?

Back 44

eating or antacids

Front 45

Nutritional advice for PUD

Back 45

decrease alcohol, spices, coffee/caffeine; increase n-3 and n-6 Fas

Front 46

Tx for PUD

Back 46

rib raising, Chapman points, thoracic inlet/abd diaphragms, vagus nerve

Front 47

Pain distribution for GERD

Back 47

neck and shoulder, sub-xiphoid pain

Front 48

Nutritional advice for GERD

Back 48

avoid dietary fat, alcohol, coffee, acidic food, spices, large meals

Front 49

4 Fs for cholecystitis

Back 49

fat, female, forty, fertile

Front 50

Pain distribution for cholecystitis

Back 50

shoulder and R scapula, RUQ

Front 51

How does SNS predispose to gallbladder infection?

Back 51

decreases bile production and relaxes gallbladder which increases stasis

Front 52

Rome 3 criteria for IBS:

Back 52

recurrent abd pain/discomfort for at least 3 days per month in last 3 mo associated with 2 or more of the following: improvement on defecation, onset assoc with change in stool freq or stool appearance

Front 53

With what disorders is IBS associated?

Back 53

major depression, anxiety, somatoform disorder, fibromyalgia, chronic fatigue, TMJ, chronic pelvic pain

Front 54

What can contribute to the IBS pain associated with gas?

Back 54

lymph edema

Front 55

Nutritional advice for IBS:

Back 55

avoid coffee, disaccharides, legumes, cabbage

Front 56

Dx: terminal ileum is inflammed through intestinal wall, abd pain, diarrhea, weight loss

Back 56

Crohn's disease

Front 57

Dx: large intestine is bleeding, diarrhea with mucous

Back 57

UC

Front 58

Dx: functional inhibition of propulsive bowel activity with no physical obstruction

Back 58

ileus

Front 59

Dx: ileus that resolves after 2-3 days, gas in sm int and colon

Back 59

post-op ileus

Front 60

Causes of ileus:

Back 60

surgery/inactivity, opioids, sepsis, hematoma, decreased K, trauma, MI, lower lobe pneumonia, pyelonephritis, int ischemia

Front 61

Contraindications to mesenteric lifts

Back 61

abscess, abd aneurysm, acute infection

Front 62

To where is the apex of the bladder attached?

Back 62

anterior abd wall by the median umbilical lig

Front 63

To where is the neck of the bladder attached?

Back 63

pubic bones

Front 64

To where does the bladder lymph drain?

Back 64

external iliac nodes

Front 65

To where does the posterior renal fascia attach?

Back 65

quadratus, psoas, vertebrae, IV discs

Front 66

To what does the superior renal fascia attach?

Back 66

diaphragm; causes kidneys to move with respiration

Front 67

Sympathetic IV: T10-11 for GU

Back 67

adrenals, kidney, upper half of ureter, gonads

Front 68

Sympathetic IV: T12-L2 for GU

Back 68

lower half of ureter, bladder, prostate, genitals

Front 69

What GU functions does sympathetic cause?

Back 69

vasoconstriction of afferent arterioles, decreased GFR and ureteral peristalsis, relaxation of detrusor muscle

Front 70

parasympathetic IV: vagus for GU

Back 70

kidney and prox ureters, gonads

Front 71

parasympathetic IV: S2-4 for GU

Back 71

distal ureters, bladder, prostate, genitals

Front 72

Inguinal lig tenderpoint

Back 72

lateral border of pubic bones near lig attachment

Front 73

Lymph drainage of gonads

Back 73

superficial venous plexus under tunica vaginalis and deep plexus in testis/epididymis -> ascend in spermatic cord -> lateral and pre-aortic nodes

Front 74

Along what muscle does the spermatic cord run?

Back 74

psoas

Front 75

Chapman point: kidney

Back 75

1 inch lateral and superior to umbilicus, ipsilaterally

Front 76

Chapman point: adrenals

Back 76

1 inch lateral and 2 inches superior to umbilicus, ipsilaterally; POST: T11-12

Front 77

Chapman point: bladder

Back 77

umbilical area; POST: T12-L2

Front 78

Chapman point: urethra

Back 78

superior margin of pubis ramus about 2 cm lateral to symphysis

Front 79

Chapman point: prostate

Back 79

myofascial tissue along posterior margin of IT band

Front 80

Most common causes of chronic kidney disease

Back 80

HTN and DM

Front 81

What is a reason BUN can be increased (unrelated to kidney)?

Back 81

GI bleeding

Front 82

Causes of acute renal failure

Back 82

glomerulonephritis, acute tubular necrosis, drugs, tumor lysis syndrome, dehydration, rhabdomyolysis

Front 83

Most common cause of UTI

Back 83

E coli

Front 84

Pain distribution for bladder infection

Back 84

suprapubic

Front 85

Lab findings for UTI

Back 85

pyuria, bacteruria, leukocyte esterase is pos, nitrite is pos if E coli

Front 86

MS problems that manifest like urolithiasis

Back 86

sacroiliac, iliolumbar ligaments

Front 87

Pain distribution for Meralgia Paresthetica

Back 87

in distribution of lateral femoral cut nerve - anterolateral thigh

Front 88

Causes of Meralgia Paresthetica

Back 88

tight clothing, pregnancy, rapid weight gain, innominate SD

Front 89

Iliolumbar tenderpoint

Back 89

1 inch superior and lateral to inferior margin of PSIS and iliolumbar ligament

Front 90

Dx: abrupt moderate to large leakage of urine due to uninhibitied bladder contractions of detrusor

Back 90

urge incontinence

Front 91

Dx: increased intraabd pressure causes sphincter opening in absence of bladder contraction

Back 91

stress incontinence

Front 92

Dx: small volume leakage due to detrusor weakness and/or bladder outlet obstruction

Back 92

overflow incontinence

Front 93

Prehn sign

Back 93

elevation of hemiscrotum relieves pain of epididymis

Front 94

Pain distribution of prostatitis

Back 94

perineal and low back pain

Front 95

Distribution of psoas pain

Back 95

lumbar to upper butt, umbilicus to ASIS and anterior thigh

Front 96

What is the osteopathic explanation for urge incontinence?

Back 96

sacral dysfunction leading to hyperstim of PNS which causes contraction of detrusor

Front 97

Chapman point: pancreas

Back 97

T7-8

Front 98

Chapman point: liver, gallbladder

Back 98

T7-9

Front 99

Chapman point: prostate

Back 99

T10-L2

Front 100

Chapman point: adrenals

Back 100

T11-12

Front 101

Chapman point: kidney

Back 101

T12-L1