Neuroanatomic Considerations

Abstract

Clinical diagnosis of acute abdomen is based on analysis and interpretation of the presenting features. A knowledge of anatomy and physiology is essential in analysis and interpretation of presenting features, in diagnosis, and in proper management; for instance, pain over the shoulder region in a patient with blunt abdominal trauma cannot be interpreted without understanding referred pain. Likewise, knowing the differences between visceral and somatic pain and the mechanisms underlying various reflex manifestations enables one to decide whether the inflammation of acute appendicitis is confined to the viscus or has spread beyond its confines. While anatomic knowledge is valuable in diagnosis, an understanding of the pathophysiology of fluid shifts, electrolyte and acid—base imbalance, hypovolemia, shock, infection, and effects of gastrointestinal distention is also of obvious importance in assessing the degree of physiologic derangement and restoring normalcy.