Nurse Zuurison

09/11/2025

✅ Abdominal Pain – Easy Guide

Abdominal pain can be understood by location. Each region suggests specific causes.

✅ Upper Abdomen

🔹 Epigastric (middle upper)

Common stomach & heart-related causes:
• Gastritis
• GERD
• Peptic ulcer disease (PUD)
• Pancreatitis
• Heart attack (MI)
• Esophagitis
• Pericarditis
• Ruptured AAA (dangerous)

🔹 Right Upper Quadrant (RUQ)

Mostly liver & gallbladder:
• Gallstones / Biliary colic
• Cholecystitis
• Cholangitis
• Hepatitis
• Pancreatitis
• Liver abscess
• Budd–Chiari (rare)

🔹 Left Upper Quadrant (LUQ)

Mostly spleen & stomach:
• Splenic infarct / rupture
• Splenic abscess
• Gastritis
• Peptic ulcer
• Pancreatitis
• Sub-diaphragmatic abscess

✅ Middle Abdomen

🔹 Periumbilical (around belly button)

Gut-related:
• Early appendicitis
• Gastroenteritis
• Small bowel obstruction
• IBS/IBD
• Ruptured AAA (dangerous)

🔹 Right Lumbar
• Kidney stones
• Pyelonephritis (kidney infection)
• Perinephric abscess

🔹 Left Lumbar

Same as right:
• Kidney stones
• Pyelonephritis
• Perinephric abscess

✅ Lower Abdomen

🔹 Right Lower Quadrant (RLQ)

The classic:
• Appendicitis
• Ectopic pregnancy
• Ovarian issues
• Hernia
• Nephrolithiasis
• IBS/IBD
• Cecal volvulus

🔹 Suprapubic / Hypogastrium

Bladder, uterus, or bowel:
• UTI / cystitis
• Urinary retention
• IBS/IBD
• Ovarian cyst

🔹 Left Lower Quadrant (LLQ)

Colon & reproductive:
• Diverticulitis
• Ectopic pregnancy
• Salpingitis
• IBS/IBD
• Nephrolithiasis
• Sigmoid volvulus

✅ Diffuse Abdominal Pain (all over)

These affect the entire abdomen:
• Gastroenteritis
• SBO (small bowel obstruction)
• Mesenteric ischemia
• Peritonitis
• IBS/IBD
• Diabetes (DKA)
• Functional or psychiatric causes
• Familial Mediterranean fever

✅ Chronic Pain
• IBS / IBD
• Dyspepsia
• Lactose intolerance
• Endometriosis
• Hernia
• Cancer (GI, GYN)

08/11/2025

Blood Compatibility

Please What's your blood group? I rep A+

08/11/2025

Uterine Leiomyoma (Fibroid)

Definition:
Uterine leiomyomas are benign smooth muscle tumors of the uterus, composed mainly of fibrous connective tissue. They are the most common pelvic tumors in women and are hormonally responsive to estrogen and progesterone .

Symptoms:
Most cases are asymptomatic, but when present, symptoms include:
• Abnormal uterine bleeding (menorrhagia, intermenstrual bleeding)
• Pelvic pressure or pain
• Increased urinary frequency or constipation (due to mass effect)
• Infertility or recurrent miscarriage
• Palpable pelvic mass

Diagnosis:
• Pelvic examination: May reveal enlarged, irregular uterus.
• Imaging: Transvaginal or pelvic ultrasound is the first-line imaging; saline infusion sonohysterography or MRI may be used to define submucosal or intramural fibroids and exclude malignancy (e.g., leiomyosarcoma) .
• Endometrial biopsy: Indicated for women >40 years or with risk factors to rule out hyperplasia or carcinoma .

Differential Diagnosis:
• Adenomyosis
• Endometrial polyps
• Endometrial carcinoma
• Ovarian mass

Treatment:
Management depends on symptoms, size, and fertility wishes:
• Medical therapy:
• Hormonal options (OCPs, progestins, GnRH agonists/antagonists) to reduce bleeding and size.
• Nonhormonal: NSAIDs and antifibrinolytics for pain and bleeding control .
• Surgical options:
• Myomectomy – preferred for women desiring fertility.
• Uterine artery embolization or laparoscopic radiofrequency ablation for uterine-sparing alternatives.
• Hysterectomy – definitive and curative for those not desiring future fertility .

Complications and Follow-up:
• Iron deficiency anemia due to heavy bleeding
• Acute hemorrhage or severe pain from degeneration
• Rarely, prolapse of submucosal fibroid through the cervix
• May obscure other gynecologic malignancies 
• In pregnancy: miscarriage, preterm labor, malpresentation, or dystocia 

Follow-up:
Monitor for recurrence or regrowth, anemia status, and assess symptom control post-therapy. Postmenopausal growth warrants evaluation for malignancy .

08/11/2025

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🧠 Cranial Nerves and Functions

I. Olfactory Nerve

Type: Sensory

Origin: Olfactory epithelium (roof of nasal cavity)

Function: Sense of smell

Pathway: Passes through cribriform plate of the ethmoid bone → olfactory bulb

Clinical note: Loss of smell = Anosmia (may occur in head injury or sinus infection)

II. Optic Nerve

Type: Sensory

Origin: Retina of the eye

Function: Vision

Pathway: Retina → Optic nerve → Optic chiasma → Optic tract → Visual cortex (occipital lobe)

Clinical note: Damage leads to blindness or visual field defects

III. Oculomotor Nerve

Type: Motor

Origin: Midbrain

Function:

Controls most eye muscles (superior, inferior, medial re**us & inferior oblique)

Raises eyelid (levator palpebrae superioris)

Pupil constriction (parasympathetic fibers)

Clinical note: Damage causes ptosis (drooping eyelid), dilated pupil, eye deviation down & out

IV. Trochlear Nerve

Type: Motor

Origin: Midbrain (posterior aspect)

Function: Controls superior oblique muscle (moves eye down and inward)

Clinical note: Lesion → difficulty looking downward (e.g., reading or stairs)

V. Trigeminal Nerve

Type: Both (sensory & motor)

Origin: Pons

Divisions:

1. Ophthalmic (V1) – forehead, eyes, scalp sensation

2. Maxillary (V2) – cheeks, upper lip, upper teeth

3. Mandibular (V3) – lower jaw sensation + chewing muscles

Clinical note: Trigeminal neuralgia – severe facial pain; loss of corneal reflex

VI. Abducens Nerve

Type: Motor

Origin: Pons

Function: Controls lateral re**us (moves eye laterally)

Clinical note: Lesion → inability to move eye outward (eye deviates inward)

VII. Facial Nerve

Type: Both

Origin: Pons

Function:

Facial expressions

Taste (anterior 2/3 of tongue)

Lacrimal and salivary gland secretion

Clinical note: Damage → Bell’s palsy (facial paralysis on one side)

VIII. Vestibulocochlear Nerve

Type: Sensory

Origin: Pons–Medulla junction

Function:

Cochlear part: hearing

Vestibular part: balance and equilibrium

Clinical note: Lesion → hearing loss, vertigo, nystagmus

IX. Glossopharyngeal Nerve

Type: Both

Origin: Medulla oblongata

Function:

Taste (posterior 1/3 tongue)

Swallowing

Salivation (parotid gland)

Monitors blood pressure via carotid sinus

Clinical note: Loss of gag reflex, difficulty swallowing

X. Vagus Nerve

Type: Both

Origin: Medulla oblongata

Function:

Parasympathetic control of heart, lungs, and digestive tract

Speech (laryngeal muscles)

Swallowing, taste (epiglottis)

Clinical note: Lesion → hoarseness, difficulty swallowing, irregular heartbeat

XI. Accessory Nerve

Type: Motor

Origin: Medulla & spinal cord

Function: Controls sternocleidomastoid and trapezius muscles (head turning, shoulder movement)

Clinical note: Weakness in turning head or shrugging shoulders

XII. Hypoglossal Nerve

Type: Motor

Origin: Medulla oblongata

Function: Tongue movements for speech and swallowing

Clinical note: Damage → tongue deviates to the affected side when protruded

🧩 Summary Table

No Nerve Name Function Summary Type

I Olfactory Smell Sensory
II Optic Vision Sensory
III Oculomotor Eye movement, pupil constriction Motor
IV Trochlear Eye movement (down & in) Motor
V Trigeminal Facial sensation, chewing Both
VI Abducens Eye movement (lateral) Motor
VII Facial Facial expression, taste, tears, saliva Both
VIII Vestibulocochlear Hearing, balance Sensory
IX Glossopharyngeal Taste, swallowing, BP regulation Both
X Vagus Heart, lungs, digestion, speech Both
XI Accessory Neck & shoulder movement Motor
XII Hypoglossal Tongue movement Motor