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350 abdominal assessment > abd assessment > Flashcards

abd assessment Flashcards

1
Q

what organs are present in RUQ

A
  1. liver
  2. gallbladder
  3. head of pancreas
  4. right kidney and right adrenal gland
  5. part of ascending and transverse colon
  6. Duodenum
  7. hepatic flexure of colon
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2
Q

what organs are present in LUQ

A
  1. left lobe of liver
  2. spleen
  3. body of pancreas
  4. left kidney and adrenal gland
  5. spleenic flexure of colon
  6. parts of transverse and descending colon
  7. stomach
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3
Q

what organs are present in RLQ

A
  1. cecum
  2. appendix
  3. right ovary and fallopian tube
  4. right spermatic cord
  5. right ureter
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4
Q

what organs are present in LLQ

A
  1. part of descending colon
  2. sigmoid colon
  3. left ovary and fallopian tube
  4. left spermatic cord
  5. left ureter
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5
Q

what organs are at the midline

A
  1. aorta
  2. uterus
  3. bladder
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6
Q

what are the layers of abdominal musculature (from inside to outside)

A

viscera-> visceral peritoneum -> parietal peritoneum -> transversus -> internal oblique -> external oblique, rectus abdominus, aponeurosis, linea alba
(point them out on the diagram as well)

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7
Q

which abdominal musculature is at the midline

A

rectus abdominus

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8
Q

name the solid viscera

A

viscera that maintain their shape

  1. liver
  2. spleen
  3. kidney
  4. adrenal glands
  5. pancreas
  6. ureter
  7. uterus
  8. aorta
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9
Q

name the hollow viscera

A

shape depends on the contents in them

  1. stomach
  2. colon
  3. bladder
  4. gallbladder
  5. small intestine
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10
Q

what are some developmental considerations for infants/children

A
  1. enlarged liver
  2. bladder is higher, almost at the level of umbilicus
  3. underdeveloped abdominal wall muscles
  4. increased risk of GI infections
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11
Q

what are some developmental considerations for pregnant women

A
  1. nausea/vomiting
  2. skin discolouration on the abdomen: striae, linea nigra
  3. aid indigestion/ heartburn : due to progesterone-> relaxed smooth muscles -> decrease in GI motility -> prolongation of gastric emptying time
  4. diminished bowel sounds: intestines are displaced
  5. constipation : due to increased level of waster absorption
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12
Q

what are some developmental considerations for older adults

A
  1. adipose tissue redistribution to hips and abdomen
  2. abdominal muscle relaxation
  3. decreased salivation = dry mouth
  4. decreased gastric acid secretion
  5. decreased liver size
  6. decreased renal functioning
  7. increased incidence of gallstones and colorectal cancer
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13
Q

what matters should you be asking for during SUBJECTIVE assessment (PQRSTUAAA)

A 
Health history:
1. appetite
> anorexia 
2. dysphasia
3. food intolerance : pyrosis 
4. abdominal pain:
> visceral pain
> parietal pain
> referred pain
5. nausea/vomiting
> hematemesis 
6. Bowel habits:
> melena stool
> frank blood
7. past abdominal history
> IBD/IBS
> colorectal cancer: can be caused by IBD, smoking, diabetes
> FAP -> causes colon cancer
8. meds: NSAIDS, Acetaminophen and ASA
9. alcohol and tobacco use -> pancreatic and esophageal cancer
10. nutritional assessment - 24 hr recall of dietary intake
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14
Q

what matters should you be asking for during OBJECTIVE assessment

A

Inspection :

  1. Contour
    - Flat (Expected)
    - Rounded (expected)
    - Scaphoid (unexpected, not eating enough)
    - Protuberant (unexpected, too much air)
  2. Symmetry
    - Umbilical hernia
    - incisional hernia
    - inguinal hernia
    - Diastasis recti
  3. Umbilicus : inverted or everted
  4. skin
  5. pulse or movement
    - aorta at the epigastric area
    - waves peristalsis across the abd
  6. hair distribution
  7. demeanor

Auscultation:

  1. Bowel sounds : in all 4 quads
    - Hypoactive
    - hyperactive : borborygmus
    - absent : paralytic ilieus
  2. vascular sounds: listening for bruit (if presenting, stop examining )
    - aorta
    - renal arteries
    - femoral arteries
    - iliac arteries

Percussion: (only when Inspection and auscultation are fine)

  1. general tympany in all 4 quads
  2. Special perussion tests:
    a. hepatomegaly : enlarged liver (>12 cm, 6-12 cm is normal), moved further down
    - scratch test
    - liver span
    b. splenomegaly- enlargement of spleen (during inspiration from tympany to dullness)
    - splenic dullness : at 9th to 11th intercostal space
    c. inflammation of the kidney
    - costovertebral angle tenderness

Palpation: for masses, enlargement of organs, tenderness

  1. light palpation
    - 1 cm deep
    - using 4 fingers
    - looking for mass/tenderness
  2. deep palpation
    - 5 to 8 cm deep
    - one or two hands
    - location, size, consistency, mobility of organs/masses, enlargement of organs, tenderness
    - can palpate liver, spleen, kidney, aorta
  3. special tests:
    a. apendicitis
    - blumberg’s sign
    - iliopsoas muscle test
    b. gallbladder inflammation
    - murphy’s sign
    c. Ascites: fluid in the abd cavity
    - fluid wave
    - shifting dullness
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15
Q

Why do we perform auscultation before percussion and palpation

A
  1. percussion and palpation can increase peristalsis, which would give false interpretation of bowel sounds
  2. if a bruit is auscultated, avoid percussion and palpation
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16
Q

which structures are normally palpable

A
  1. xiphoid process
  2. normal liver edge
  3. right kidney
  4. pulsatile aorta
  5. rectus muscles
  6. sacral promontory
  7. cecum ascending colon
  8. sigmoid colon
  9. uterus (gravid)
  10. full bladder

350 abdominal assessment (1 decks)

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