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Physical Assessment > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What is the posterior landmark of the abdomen?

A

Costovertebral angle (CVA)
-formed by the lower border of the 12th ribs and upper lumbar vertebrae
-areas to asses for kidney tenderness

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2
Q

What are the major organs of the RUQ?

A

Liver
Gallbladder
Pylorus
Duodenum

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3
Q

What are the major structures of the LUQ?

A

Stomach
Spleen
Left lobe of liver

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4
Q

What are the major organs of the RLQ?

A

Cecum
Appendix
Right ovary
Right ureter

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5
Q

What are the major organs of the LLQ?

A

Sigmoid colon
Left ureter
Left spermatic cord

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6
Q

What can cause RUQ pain?

A

Cholecystitis
Renal Stone
Intestinal obstruction
Stomach inflammation

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7
Q

What can cause LUQ pain?

A

Pancreatitis
Renal stone
Intestinal obstruction
Stomach inflammation

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8
Q

What can cause RLQ pain

A

Appendicitis
PID
Ruptured ovarian cyst

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9
Q

What can cause LLQ pain?

A

Diverticulitis
bowel obstruction

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10
Q

What is heartburn?

A

a burning sensation in the epigastric area radiating into the throat; often associated with regurgitation

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11
Q

What is excessive gas or flatus?

A

needing to belch or pass gas by the rectum; patients often state they feel bloated

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12
Q

What is abdominal fullness?

A

Early satiety
- starting eating but feeling full after a couple bites

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13
Q

What is regurgitation/

A

the reflux of food and stomach acid back into the mouth; brine-like taste

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14
Q

What is blood or coffe ground emesis?

A

Hematemesis

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15
Q

What is visceral pain?

A

Hollow abdominal organs contracts forcefully or distended or stretched
- gnawing, burning, cramping, aching

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16
Q

What is parietal pain?

A

originates from inflammation from hollow or solid organs that affect the parietal peritoneum, called peritonitis
-more severe than visceral
-aggravated by movement

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17
Q

What is referred pain?

A

Originates at different sites but shares innervation form the same spinal level

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18
Q

What is a Kehr sign?

A

Abdominal pain radiating to left shoulder
-sign of splenic rupture or renal colic

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19
Q

What is hematochezia?

A

Blood in stool

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20
Q

What is Melena?

A

Black tarry stool

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21
Q

What can white or gray stools indicate?

A

Liver or gall bladder disease

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22
Q

What is the most common disorder of the esophagus?

A

GERD

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23
Q

How does GERD happen?

A

Incompetent LES allows stomach acid to go back up

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24
Q

What are common signs and symptoms of GERD?

A

S: Barrett’s esophagitis, strictures
Sx: heartburn (pyrosis), regurgitation, dysphagia

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25
Q

What is Peptic Ulcer Disease?

A

Due to infection (helicobacter pylori)

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26
Q

What are the signs and symptoms of PUD?

A

S:Melena, hematochezia, anemia
Sx: epigastric pain, cramping

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27
Q

Acute and chronic symptoms of diarrhea?

A

Acute: cramping, nausea, watery stools
Chronic: skin breakdown, dehydration, weight loss

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28
Q

What causes jaundice?

A

Increased levels of bilirubin
- bile pigment from hemoglobin breakdown

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29
Q

What is the mechanisms behind jaundice?

A

Increased production of bilirubin
Decreased uptake of bilirubin
Decreased ability of the liver to conjugate
Decreased excretion of bilirubin into bile

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30
Q

What is the urine color and stool color of jaundice

A

Urine: dark yellowish, brown
Stool: stools become gray or light colored

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31
Q

What are the 7 F’s of abdominal distension?

A

Fluid
Feces
Fetus
Fat
Flatus
Fatal tumor
Fibroid

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32
Q

What areas of the abdomen should be exposed?

A

Xiphoid process to suprapubic area

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33
Q

What is the order of the physical exaM?

A

Inspection
Auscultation
Percussion
Palpation

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34
Q

What is the medical term for stretch marks/

A

Striae

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35
Q

Is peristalsis typical seen?

A

NO
-may be seen in thin people
-Seen with bowel obstruction

36
Q

Are aortic pulsation visible?

A

Yes

37
Q

What is a Cullen Sign?

A

Bluish periumbilical discoloration
-Suggest intraabdominal bleeding

38
Q

What is a grey turner sign?

A

Ecchymosis of the flanks
-Suggest hemoperitoneum

39
Q

What color will striae turn over time?

A

Turn silvery-white
-initially pink or blue

40
Q

If someone has Cushing disease what would the striae remain?

A

Purplish

41
Q

When will you see a flat, rounded, scaphoid, distended, or protuberant abdomen

A

Flat: athletic
Rounded: young children
Scaphoid: thin, or malnourished
Distended: abnormal state
Protuberant: pregnancy, FAT MC

42
Q

What are dilate veins called?

A

Caput Medusa

43
Q

What is rectus diathesis?

A

Separation of rectus abdominis muscles with central linear bulging

44
Q

What are bowel sounds a result of?

A

Peristalsis

45
Q

What is normoactive bowel sounds

A

5-34 sounds per minute

46
Q

What is Borborygmi

A

Stomach growling
-prolonged gurgles of hyperperistalsis

47
Q

What are hypoative bowel sounds?

A

May require up to 2 minutes to confirm diminished
-found in ileus, paralysis of bowel, and peritonitis
-complete absence indicates ischemic or infaracted bowel

48
Q

What is a hyperactive bowel sounds?

A

Greater than 34 sounds per minute
-high pitched, or tinkling sounds

49
Q

What does a bruit sound like?

A

Whooshing

50
Q

What side of the stethoscope do you use when assessing for bruits?

A

Bell over the arteries
-listen in CVA for kidneys

51
Q

Where to listen to the abdominal aorta/

A

Between the xiphoid process and umbilicus

52
Q

What does liver and spleen friction rubs indicate?

A

Peritoneum
- grating or rasping sounds (during inspiration)

53
Q

What side of the stethoscope do you use for friction rubs liver and spleen?

A

Diaphragm

54
Q

What is percussion used for?

A

To asses the size and density of organs and detect the presence of fluid, air, or solid masses

55
Q

After the general inspection is done what organs to you have to go back to percuss?

A

Liver
Spleen
Gastric air bubble
Bladder distension
Kidneys

56
Q

What is a normal size of a liver?

A

6-12cm

57
Q

Where is the spleen located?

A

Left mid-axillary line
-ribs 9,10, and 11 protect the spleen

58
Q

How does the spleen enlarge?

A

Anteriorly, inferiorly, medially

59
Q

Can a normal filled bladder be palpable?

A

No

60
Q

What is the kidney percussion called?

A

Lloyd punch
-should not cause pain or tenderness

61
Q

What does +CVS tenderness suggest?

A

Pyelonephritis or musculoskeletal cause

62
Q

If there is distention of inflammation of the kidneys what will the patient do when struck?

A

Jumped

63
Q

When is Tympany heard?

A

Over air-filled structures
-abdomen
-stomach
-bowel obstruction

64
Q

When is dullness heard?

A

Over filled or solid organs
-enlarged bladder
-liver
-spleen
-constipated

65
Q

If someone is in serve pain what order should you palpate?

A

Tender area last
-ask patient to cough
-will guard that area

66
Q

How many hands is light and deep Palpation used with?

A

Light: one hand
Deep: two hands (kneading)

67
Q

How to determine a superficial or deep mass?

A

Superficial: stays with crunch
Deep: disappears with crunch

68
Q

When is the hook technique used for liver Palpation

A

In obese patients

69
Q

Is it okay to palpate for a spleen?

A

No it needs to be investigated

70
Q

If a spleen is enlarged how will it move?

A

anterior, downward, and medially displacement

71
Q

What is an enlarged aorta?

A

3cm

72
Q

What is occult blood?

A

Cannot see with naked eye

73
Q

What is acute abdomen synonymous with?

A

Peritonitis (inflammation of the parietal peritoneum)
-tell them to cough

74
Q

What is rebound tenderness?

A

Deep Palpation vs sudden lifting
-withdrawal pain=peritoneal irritation (+ rebound)

75
Q

What is guarding?

A

Voluntary
-tensing of the abdominal muscles
-sign of acute peritonitis

76
Q

What is rigidity?

A

Involuntary reflex contraction of abdominal muscles
-board-like abdominal structures

77
Q

What is classic appendicitis?

A

Inflammation of the appendix
-localized periumbilical pain followed by RLQ

78
Q

What is McBurney’s point?

A

2 inches from ASIS is McBurney’s Point
-where appendix is

79
Q

What is Rovsing sign/

A

Pain referred to RLQ when pressing deeply in the LLQ

80
Q

What is Psoas sign?

A

peritoneal irritation over Psoas will cause pain in RLQ

81
Q

What is the obturator sign?

A

Least sensitive test
-flex right hip and knee at 90 degrees

82
Q

What is Murphy sign?

A

Performed in patients with RUQ pain
-suggest acute cholecystitis
- inspiratory arrest (+)

83
Q

What is ascities?

A

Accumulation of fluid in the abdominal cavity
-protuberant abdomen
- heart failure or cirrhosis

84
Q

Fluid wave ascites or adipose?

A

Ascites: fluid moves under the hand
Adipose: tap stops at the hand placed in midline

85
Q

What is ballottement?

A

Used to identify an organ or mass
-make a brief jabbing movement toward the structure

86
Q

What is the most common cause of flank pain?

A

Hydronephrosis
Pyelonephritis

Physical Assessment (12 decks)

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