Abdomen Flashcards
What is the origin/insertion of the rectus abdominis?
origin: pubis, insertion: costal cartilages of ribs 5-7
What nerves innervate the rectus abdominis?
Nerve roots T7 - T12
What are the layers of the abdominal wall from most superficial to deep?
Skin, Camper’s fascia, Scarpa’s fascia, Rectus abdominis, External Oblique, Internal Oblique, Transverse abdominis, Pyramidalis muscle, Fascia, Pertonium
Does the aorta bifurcate above or below the umbilicus?
above
where is the gallbladder palpated anatomically?
R MCL
Which renal artery is longer?
right
Which kidney is positioned lower than the other?
right
What could Costovertebral angle tenderness indicate?
pyelonephritis or MSK
Where are bruits in the renal arteries auscultated?
on the posterior side of the abdomen
which artery generally bleeds with a stomach ulcer?
gastroduodenal
why is the order of inspection (inspection, auscultation, percussion, palpation) important especially on the abdominal exam?
you don’t want to cause pain with palpation before inspection of the pt
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Know these incisions for common surgical procedures
what abdominal finding would be noted in a pt with Cuchings?
large abdomen with striae
caput medusae is a sign of?
portal HTN, liver failure
What is diastasis recti?
not technically a hernia - can become one, due to a weak linae alba
how can you test for diastasis recti?
have the pt do a crunch, the abdomen should not bulge
what populations are at risk for developing diastasis recti?
pre-mature infants, pregnant women
What “technically” is required before documentation of no bowel sounds?
2 minutes of no bowel sounds
what might cause increased bowel sounds?
gastroenteritis, hunger, early obstruction
what might cause decreased bowel sounds?
peritonitis, adynamic ileus, late obstruction
what can cause adynamic ileus?
surgery or anesthesia, gallstones
most of the abdomen should sound tympanic on percussion except…
it is over a solid organ, the pt has just eaten, or if the pt is constipated
what is WNL for liver span?
6-12cm
how is splenic percussion performed?
percuss the lowest ICS, have pt take in a deep breath, percuss over the same area and it shouldn’t change
methods for relaxing a ticklish patient?
have the take a deep breath in, bend knees to relax abdominal muscles
where should palpation always be directed last during the exam?
the most tender area