NUR530 – GI Study Guide Exam
Questions And Actual Answers.
Structures in right upper quadrant - Answer liver
gallbladder
pylorus
duodenum
hepatic flexure of colon
head of pancreas
Structures of left upper quadrant - Answer spleen
splenic flexure of colon
stomach
body and tail of pancreas
transverse colon
Structures of left lower quadrant - Answer sigmoid colon
descending colon
left ovary
Structures of right lower quadrant - Answer cecum
appendix
ascending colon
right ovary
What abdominal structures often are not palpable: - Answer exceptions to palpation are usually liver,
spleen, gallbladder, stomach, pancreas, appendix, ovaries, kidneys
,This pain occurs when hollow abdominal organs such as intestine or biliary tree contract unusually
forcefully or are distended or stretched. Solid organs such as the liver can also become painful when
their capsules are stretched. This pain may be difficult to localize. It is typically palpable near the midline
at levels that vary according to structure involved. - Answer Visceral pain
Visceral pain in RUQ suggests what? - Answer liver distention against its capsule from various causes of
hepatitis, including alcoholic hepatitis
Ischemia stimulates this pain - Answer Visceral pain
This type of pain varies in quality and may be gnawing, burning, cramping, or aching. When it becomes
severe, sweating, pallor, nausea, vomiting and restlessness may follow - Answer Visceral pain
Visceral periumbilical pain suggests what - Answer early acute appendicitis from distention of an
inflamed appendix
Explain the progression of appendicitis pain - Answer Periumbilical pain from distention of an inflamed
appendix which gradually changes to parietal pain in the RLQ from inflammation of the adjacent parietal
peritoneum
For pain disproportionate to physical findings, suspect what - Answer intestinal mesenteric ischemia
Types of visceral pain - Answer RUQ or epigastric pain from biliary tree and liver
Epigastric pain from stomach, duodenum, pancreas
Periumbilical pain from small intestine, appendix, proximal colon
Suprapubic or sacral pain from rectum
Hypogastric pan from colon, bladder or uterus. colon pain may be more diffuse than illustrated
This type of pain originates from inflammation of the parietal peritoneum, called peritonitis - Answer
Parietal pain
,This is a steady, aching pain that is usually more severe than visceral pain and more precisely localized
over the involved structure. It is typically aggravated by movement or coughing. Patients typically prefer
to lie still. - Answer Parietal pain
In contrast to peritonitis, patients with colicky pain from renal stone present how? - Answer move
around frequently trying to find comfortable position
This pain is felt in more distant sites which are innervated at approximately the same spinal levels as the
disordered structures. - Answer Referred pain
This type of pain often develops as the initial pain becomes more intense and seems to radiate or travel
from the initial site. It may be palpated superficially or deeply but is usually localized - Answer Referred
pain
Pain may be referred to the abdomen from where? - Answer chest, spine, pelvis
Pain of duodenal or pancreatic origin may be referred where? - Answer to the back, pain from biliary
tree to the right scapular region or right posterior thorax
Pain from pleurisy or inferior wall MI may be referred to - Answer epigastric area
Studies suggest that symptoms of pain, bowel dysfunction, and stress of the gut are mediated by what? -
Answer neuropeptides like 5-hydroxytryptophan and substance P
doubling over with cramping colicky pain indicates - Answer renal stone
Sudden knife like epigastric pain often radiating to the back is typical of - Answer pancreatitis
Epigastric pain occurs with - Answer GERD, pancreatitis, perforated ulcers
RUQ and upper abdominal pain are common in - Answer cholecystitis and cholangitis
, Severity of pain-sensitivity varies widely and tends to have what pattern in older adults? - Answer
diminish
When asking about location of pain, what is also important to get the most information? - Answer ask
patient to point to pain
As you explore factors that aggravate or relieve pain, pay special attention to: - Answer body position
association with meals
alcohol
medications (asa, antacids)
stress
Ask if indigestion or discomfort is related to - Answer exertion relieved by rest
This may present as indigestion precipitated by exertion and relieved by rest - Answer angina from
inferior wall coronary artery disease
This is defined as chronic or recurrent discomfort or pain centered in the upper abdomen, characterized
by post prandial fullness, early satiety, and epigastric pain or burning - Answer dyspepsia
This is defined as a subjective negative feeling that is non painful. It can include various symptoms such
as bloating, nausea, upper abdominal fullness, and heartburn - Answer discomfort
What does NOT need the criteria for dyspepsia? - Answer when bloating, nausea or belching occur
alone
Bloating may occur with - Answer lactose intolerance, inflammatory bowel disease, ovarian cancer
Belching may result from - Answer aerophagia-swallowing air
Questions And Actual Answers.
Structures in right upper quadrant - Answer liver
gallbladder
pylorus
duodenum
hepatic flexure of colon
head of pancreas
Structures of left upper quadrant - Answer spleen
splenic flexure of colon
stomach
body and tail of pancreas
transverse colon
Structures of left lower quadrant - Answer sigmoid colon
descending colon
left ovary
Structures of right lower quadrant - Answer cecum
appendix
ascending colon
right ovary
What abdominal structures often are not palpable: - Answer exceptions to palpation are usually liver,
spleen, gallbladder, stomach, pancreas, appendix, ovaries, kidneys
,This pain occurs when hollow abdominal organs such as intestine or biliary tree contract unusually
forcefully or are distended or stretched. Solid organs such as the liver can also become painful when
their capsules are stretched. This pain may be difficult to localize. It is typically palpable near the midline
at levels that vary according to structure involved. - Answer Visceral pain
Visceral pain in RUQ suggests what? - Answer liver distention against its capsule from various causes of
hepatitis, including alcoholic hepatitis
Ischemia stimulates this pain - Answer Visceral pain
This type of pain varies in quality and may be gnawing, burning, cramping, or aching. When it becomes
severe, sweating, pallor, nausea, vomiting and restlessness may follow - Answer Visceral pain
Visceral periumbilical pain suggests what - Answer early acute appendicitis from distention of an
inflamed appendix
Explain the progression of appendicitis pain - Answer Periumbilical pain from distention of an inflamed
appendix which gradually changes to parietal pain in the RLQ from inflammation of the adjacent parietal
peritoneum
For pain disproportionate to physical findings, suspect what - Answer intestinal mesenteric ischemia
Types of visceral pain - Answer RUQ or epigastric pain from biliary tree and liver
Epigastric pain from stomach, duodenum, pancreas
Periumbilical pain from small intestine, appendix, proximal colon
Suprapubic or sacral pain from rectum
Hypogastric pan from colon, bladder or uterus. colon pain may be more diffuse than illustrated
This type of pain originates from inflammation of the parietal peritoneum, called peritonitis - Answer
Parietal pain
,This is a steady, aching pain that is usually more severe than visceral pain and more precisely localized
over the involved structure. It is typically aggravated by movement or coughing. Patients typically prefer
to lie still. - Answer Parietal pain
In contrast to peritonitis, patients with colicky pain from renal stone present how? - Answer move
around frequently trying to find comfortable position
This pain is felt in more distant sites which are innervated at approximately the same spinal levels as the
disordered structures. - Answer Referred pain
This type of pain often develops as the initial pain becomes more intense and seems to radiate or travel
from the initial site. It may be palpated superficially or deeply but is usually localized - Answer Referred
pain
Pain may be referred to the abdomen from where? - Answer chest, spine, pelvis
Pain of duodenal or pancreatic origin may be referred where? - Answer to the back, pain from biliary
tree to the right scapular region or right posterior thorax
Pain from pleurisy or inferior wall MI may be referred to - Answer epigastric area
Studies suggest that symptoms of pain, bowel dysfunction, and stress of the gut are mediated by what? -
Answer neuropeptides like 5-hydroxytryptophan and substance P
doubling over with cramping colicky pain indicates - Answer renal stone
Sudden knife like epigastric pain often radiating to the back is typical of - Answer pancreatitis
Epigastric pain occurs with - Answer GERD, pancreatitis, perforated ulcers
RUQ and upper abdominal pain are common in - Answer cholecystitis and cholangitis
, Severity of pain-sensitivity varies widely and tends to have what pattern in older adults? - Answer
diminish
When asking about location of pain, what is also important to get the most information? - Answer ask
patient to point to pain
As you explore factors that aggravate or relieve pain, pay special attention to: - Answer body position
association with meals
alcohol
medications (asa, antacids)
stress
Ask if indigestion or discomfort is related to - Answer exertion relieved by rest
This may present as indigestion precipitated by exertion and relieved by rest - Answer angina from
inferior wall coronary artery disease
This is defined as chronic or recurrent discomfort or pain centered in the upper abdomen, characterized
by post prandial fullness, early satiety, and epigastric pain or burning - Answer dyspepsia
This is defined as a subjective negative feeling that is non painful. It can include various symptoms such
as bloating, nausea, upper abdominal fullness, and heartburn - Answer discomfort
What does NOT need the criteria for dyspepsia? - Answer when bloating, nausea or belching occur
alone
Bloating may occur with - Answer lactose intolerance, inflammatory bowel disease, ovarian cancer
Belching may result from - Answer aerophagia-swallowing air
