The Abdomen

• Abdominal Anatomy
• The History and Physical in Perspective
• Key Historical Points - Abdominal Pain
  • Types of Abdominal Pain

Most of the abdominal organs are found within the peritoneum. These organs can and do "move" (during pregnancy for example). Certain structures, such as the kidneys and pancreas, are retroperitoneal.

The History and Physical in Perspective

• 70% of diagnoses can be made based on history alone.
• 90% of diagnoses can be made based on history and physical exam.
• Expensive tests often confirm what is found during the history and physical.

• Time Course
• Location/Quality
• Radiation
• Associated Symptoms

• Pain from Hollow Viscera
  • crampy/paroxismal
  • often poorly localized
  • related to peristalsis
  • patient writhing on exam table
• Pain from Peritoneal Irritation
  • steady/constant
  • often localized
  • patient lies still with knees up