Abdo Flashcards
What should you look at in the inspection aspect of abdo exam?
Distention
Pallor
Jaundice
Hyperpigmentation - bronzing of skin associated with haemochromatosis
Oedema
Cachexia - muscle loss not associated with nutritional supplementation
Hernias
What is myoclonus of the hands?
Stretch patients hands out and bend wrists back to 90 degrees with finger splayed out and observe for 20 secs. If a tremor occurs it may indicate possible co2 retention.
What are all of the head and neck lymph nodes?
Preauricular (in front of ears)
Posteriorauricular (behind ears)
Parotid (underneath pre auricular)
Tonsillar (behindnext to mandible)
Submental (under chin)
Submandibular (under mandible)
Occipital (back of head on neck)
Deep and posterior cervical ( on neck middle on the sides)
Supraclavicular
Where does the left supraclavicular node receive drainage from?
The abdominal cavity
Where does the right supraclavicular node receive drainage from?
The thorax
What is Cullens sign?
Bruising around belly button. sign of haemorrhage pancreatitis
What is grey turners sign?
Bruising in the flanks associated with hemorrhagic pancreatitis
Auscultation landmarks for abdomen?
Aorta - Midline a few cm above umbilicus
Renal (Left and Right) - a few cm lateral to the aorta
Iliac (Left and Right) - a few cm inferior to umbilicus
Femoral (Left and right) - On inguinal lines
Where should a dull/thud sound be in abdo percussion?
Dense areas
Liver
Spleen
Where would a flat/stony/dull
Over bone
How much bowel sounds would you here per minute?
5-30 per min
Where would you hear hollow higher pitched sounds?
Over the stomach
How long is the liver?
6-12cm
Landmark for liver percussion
Right midclavicular
Start at 3rd intercostal space
The sound will change from resonant (over lungs) to dull when you reach the liver (around 5th intercostal space)
Then begin percussing upwards from below the right costal margin (around umbilicus)
Where should you percuss the spleen?
8th/9th intercostalspace in the anterior axillary line left side
Ask pt to take deep breath then percuss
If dull then splenomegaly
What is the pinch test and what does it test for?
Pinch abdo skin over pts right hip.
The release quickly, if it hurts then positive for peritonitis
Where is Murphys sign and what does it test for?
Right midclavicular costal margin
Tests for cholecystitis
Where do you test for ballot test and what does it test for?
- Left hand on patient’s back
(flank area) under the 12th rib,
pushing upwards - Right hand pushing down just
below the (anterior) costal
margin. - Ask the patient to take a deep
breath to help descend the
kidney and ‘trap it’ between your
two hands. - Easily palpable and/or tender
kidney is abnormal =
(hydronephrosis or
pyelonephritis)
Where is CVA tenderness test?
- Find the CVA by assessing for
posterior 12th rib and the spine…just
below the 12th rib in between the
spine is the angle. - Lay non-dominate hand flat over the
angle. - Make fist with dominate hand and
firmly thump the fist onto flat non-
dominate hand. - Ask the patient if they felt
tenderness or pain = if yes likely
pyelonephritis
What is rovsing sign?
RLQ pain of palpation of LLQ
What is psoas sign?
RLQ pain with extension of right hip with resistance
What is Mallory-Weiss Tear?
Tear/laceration of the mucous membrane, most commonly at the point where the oesophagus and the stomach meet
What is steatorrhoea?
The presence of excess fat in the faeces causing them to appear pale and difficult to flush
What is mesenteric adenitis?
Inflammation of the lymph nodes in the mesentery.
It typically affects the lymph nodes in the LRQ, near appendix.
