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Year 2 Clinical skills > Abdo > Flashcards

Abdo Flashcards

1
Q

pain originating in umbilicus and migrating to Right iliac fossa

A

Appendicitis

pain in Right iliac fossa

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2
Q

what does an AAA feel like on examination?

A

pulsatile and expansile

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3
Q

where does a UT stone never present?

where does it commonly present?

A

bladder
pain in flank region

across the sacroiliac joint
The pelvic-ureteric junction
Vesicoureteric junction

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4
Q

liver cirrhosis examination signs?

A

Guarding
Hepatomegaly on palpation and percussion
Jaundice on inspection

Shifting dullness to percussion

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5
Q

subcostal plane

A

level of 10th costal margin and vertebra body L3

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6
Q

intertubecular line

A

L5

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7
Q

aorta bifurcates?

A

L4

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8
Q

oesophageal hiatus?

A

T10

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9
Q

IVC

A

t8

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10
Q

aortic haitus - 12 letters

A

t12

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11
Q

retroperitoneal space?

SAD PUCKER

A 
suprarenal glands
aorta/IVC
duodenum [except proximal 2cm]
pancreas [ only head]
ureters 
colon [ascending/ descending]
kidneys
oesophagus 
rectum
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12
Q

referred shoulder pain?

A

gallbladder/liver , irritation of diaphragm = shoulder pain

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13
Q

quadrants of stomach

A

9:R- hypochondrium, epigastric, L hypochondrium
R flank, Umbilical, L flank
R iliac, hypogastrium, L iliac

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14
Q

Distended and everted umbilicus?

A

umbilical hernia

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15
Q

deep palpitation

A

upper hand (usually the left hand) is used to exert pressure, while the lower hand is used to feel the organs or masses much deeper in the abdominal cavity

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16
Q

tenderness with minimum pressure?

A

peritonitis if over a wide area

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17
Q

voluntary guarding

A

if palpitation causes pain the abdominal wall contracts voluntarily - so this

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18
Q

rigidity?

A

inflammation of parietal peritoneum > reflex contraction

no movement on respiration
board like rigidity to stomach

involuntary guarding

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19
Q

rebound tenderness?

A

pain on removal of pressure/hand

indicative of peritonitis

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20
Q

auscultation
tinkling
high pitched and frequent

A

early sign of small bowel obstruction

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21
Q

no bowel sounds?

A

rupture/ strangulation > necrosis of bowel tissue

ischemia

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22
Q

paralytic ileus

A

no bowel sounds

23
Q

vascular bruits

Bruits are _____ created by ___ blood flow in an ___ affected by ______ or _____

A

Bruits are abnormal sounds created by turbulent blood flow in an artery affected by aneurysm or obstruction

24
Q

where to listen to bruits?

A

Abdominal aorta– just above and left of the umbilicus

Superior mesenteric or coeliac arteries – epigastrium

Renal arteries - 2- 3 cm super and lateral to the umbilicus

Liver tumours – over the liver

Iliac arteries – in the iliac fossa.

25
Q

the liver moves __ _____ in _____

A

The liver moves with the diaphragm in respiration

26
Q

SM liver

A

superior border follows diaphragm - R 5th rib at the MCL extends across to inferior sternum to the L 5th Intercostal space at the MCL

inferior border
costal margin R mid axillary line through to tip of the r 9th costal Cartilage > tip of L 8th CC > L 5th ICS in MCL

27
Q

is the liver palpate-able?

A

no in healthy adults

yes in children - 16yrs as extends below costal margin

28
Q

palpating liver in children why possible?

A

yes in children - 16yrs as extends below costal margin

1-3.5 cm

29
Q

cholelithiasis

A

gallstones

30
Q

SM gallbladder

A

where the MCL meets the transpyloric plane at tip of right 9th CC

this is where the lateral border of the rectus abdominis cross the costal margin

31
Q

SM spleen

A

lateral borders of left erector spinae muscles and left MAL

lies along medial surfaces of 9th, 10th and 11th ribs

separated from rib cage by diaphragm costodiaphragmatic and recess

32
Q

hwo much does spleen have to enlarge before it becomes palpable ?

A

3/4 times

33
Q

transpyloric plane

A

L1 - 9 CC

34
Q

supracristal

A

most superior part of iliac crest - L4

35
Q

how much does spleen have to enlarge before it becomes palpable ?

A

3/4 times

36
Q

L4

A

iliac crest

37
Q

shifting dullness

A

percuss from midline to flank [towards self] midline should be tympanic / resonant and flanks dull

if when turned away from you- so lying on side they flank becomes resonant = shifting dullness = ascites

area of dullness becomes resonant = ascites are present

38
Q

shifting dullness

how long do you wait?

A

percuss from midline to flank [towards self] midline should be tympanic / resonant and flanks dull

30 seconds

if when turned away from you- so lying on side they flank becomes resonant = shifting dullness = ascites

area of dullness becomes resonant = ascites are present

39
Q

t12 posteriorly marked how?

A

half way between the inferior angle of the scapula and the highest point of the iliac crest at the scapular line

40
Q

kidney sm

A

T12 then 1 vertebral level down to get L1
kidneys should be in this plane

3-4cm from Supracristal plane
4-5cm hilum to PM line

41
Q

what other way to test ascites?

A

thrills

42
Q

bruits suggest?

A

stenosis- renal iliac
tumour-liver
over aorta : AAA

43
Q

bruits suggest?

A

stenosis- renal iliac
tumour-liver
over aorta : AAA

44
Q

balloting kidneys

A

deep breaths to capture kidneys

45
Q

AAA how much dilation?

presentation

A 
1.5
ab pain
back pain 
decision to operate is based on size 5.5cm or more 
back/flank pain 
hypotension  and pulsatile and expansi;e
46
Q

pancreatitis presentation

A

can you eat?
anorexia
epigastric pain radiates to back
raised amylase/lipase

47
Q

cause of pancreatitis?

A

perforated duodenal ulcer

48
Q

grey turner sign?

A

bruising in flanks

haemorrhagic pancreatitis

49
Q

cullens sign

A

umbilicus bruising

haemorrhagic pancreatitis

50
Q

caput medusae?

A

paraumbilical veins

portal hypertension

51
Q

causes of hepatomegaly

A

hepatitis

hemolytic anaemia

52
Q

causes of splenomegaly

A

hemolytic anaemia
portal hypertension
congestive HF

53
Q

kidney enlargement causes

A

polycystic kidney disease

Year 2 Clinical skills (6 decks)

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