abdomen

Question 1

Abdominal wall divided into four quadrants

Answer 1

Right upper (RUQ)
Left upper (LUQ)
Right lower (RLQ)
Left lower (LLQ)

Question 2

Layer of Abdomen

Answer 2

Skin
Subq
Muscle
Fascia
peritoneum

Question 3

occurs when the parietal peritoneum becomes inflamed, as in appendicitis or peritonitis. This type of pain tends to localize more to the source and is characterized as a more severe and steady pain.

Answer 3

parietal pain

Question 4

occurs at distant sites that are innervated at approximately the same levels as the disrupted abdominal organ. This type of pain travels, or refers, from the primary site and becomes highly localized at the distant site.
E.g. pancreatitis – pain felt in the shoulder

Answer 4

Referred pain

Question 5

occurs when hollow abdominal organs, such as the intestines, become distended or contract forcefully or when the capsules of solid organs such as the liver and spleen are stretched. Poorly defined or localized and intermittently timed, this type of pain is often characterized as dull, aching, burning, cramping, or colicky

Answer 5

Visceral Pain

Question 6

When did the pain begin?

Answer 6

Onset

Question 7

Point to the area where you have the pain.

Answer 7

Location

Question 8

How long the pain last- prolonged/intermittent

Answer 8

Duration

Question 9

how bad the pain

Answer 9

Severity

Question 10

when does the pain occur

Answer 10

pattern

Question 11

pain associated with other symptoms

Answer 11

Associated factor

Question 12

ACUTE or chronic gastric disorder—hyperacidity, gastroesophageal reflux(GERD) , peptic ulcer disease, stomach cancer

Answer 12

Indigestion

Question 13

Often described as “feeling sick to my stomach,” may progress to retching and vomiting.
Triggered by any particular activities, events, or other factors ( smells, eating food, riding car,boat, strenous physical activities
Dietary intolerance, menstruation, pregnancy, psychological triggers
Motion – inner ear

Answer 13

nausea

Question 14

describes involuntary spasm of the stomach, diaphragm, and esophagus that precedes and culminates in

Answer 14

Retching

Question 15

the forceful expulsion of gastric contents out of the mouth.
Associated with impaired gastric motility or reflex mechanism
Description of vomitus(emesis) –clue of source
BRIGHT HEMATEMESIS- bleeding esophageal varices, ulcers in stomach or duodenum
DARK HEMATEMESIS- Intestine

Answer 15

Vomiting

Question 16

general complaint often associated with digestive orders, chronic syndromes, cancers, and psychological disorders.
Carefully correlate appetite changes with dietary history and weight monitoring

Answer 16

Anorexia

Question 17

A decrease in the frequency of bowel movement or the passage of hard and possibly painful stools.
-Signs and symptoms that accompany constipation may be a clue to the cause.

Answer 17

Constipation

Question 18

Frequency of bowel movement producing unformed or liquid stool.

Answer 18

Diarrhea

Question 19

not actually vomit but raise esophageal or gastric contents without nausea or retching, called

Answer 19

Regurgitation

Question 20

Methods(in order)

Answer 20

IAperpal

Question 21

a physical exam finding of ecchymoses, or bruising, around the umbilicus. This sign indicates either intraperitoneal or retroperitoneal hemorrhaging.

Answer 21

Cullen’s Sign

Question 22

Classically, it is associated with severe acute pancreatitis but can be associated with a number of other conditions causing retroperitoneal bleeding such as ruptured abdominal aortic aneurysm.

Answer 22

Grey Turner’s Sign

Question 23

6Fs major causes of abdominal distention

Answer 23

FATS ,FECES, FETUS,FIBROIDS, FLATULENCEAND FLUIDS

Question 24

occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in theabdominalwall.Herniasare most common in theabdomen, but they can also appear in the upper thigh,bellybutton, and groin areas

Answer 24

Hernia

Question 25

occurs when the bowel protrudes through the separation between the 2 rectus abdominis muscles
Appear only when the client raises the head or coughs.
-little significance

Answer 25

DIASTASIS RECTI

Question 26

is thesoundthat gas makes as it moves through the intestines.
It’s often called “stomach growling” or “stomach rumbling.”

Answer 26

Borborygmi

Question 27

are considered as one every three to five per minutes diminished bowel motility

Answer 27

HYPOACTIVE BOWEL SOUNDS

Question 28

can sometimes be heard even without a stethoscope.Hyperactive bowel soundsmean there is an increase inintestinal activity. Thismayhappen with diarrhea,gastroenteritis, use of laxatives or after eating

Answer 28

INCREASED (HYPERACTIVE)bowel sounds

Question 29

not normally heard but may be normal to some client – confined to systole

Answer 29

bruits

Question 30

—whoosing sound

Answer 30

ANEURYSM OR RENAL ARTERIAL STENOSIS—

Question 31

technique to ascertain the location and size of the liver and spleen
-useful if abdomen is rigid, distended, obese or too tender to palpate

Answer 31

Scratch test

Question 32

Stand in the right of the clients chest. Curl (hook) the fingers of both hands over the edge of the right costal margin. ask the client to take a deep breath and gently pull firmly pull inward and upward with the fingers.

Answer 32

Hooking technique

Question 33

The client has rebound tenderness when he or she perceives sharp, stabbing pain as the examiner releases pressure from the abdomen

Answer 33

Blumberg’s Sign

Question 34

pain in the RLQ during pressure in the LLQ is positive rovsing’s sign

Answer 34

Rovsing’s Sign

Question 35

pain in the RLQ when leg is hyperextended. It is associated with irritation of the iliopsoas muscle due to appendicitis
- Ask the client to lie on the left side. Hyperextend the client’s right leg.

Answer 35

Psoas Sign

Question 36

pain in RLQ when the hip and knee are flexed and leg is rotated internally and externally due to irritation of the obturator muscle

Answer 36

Obturator’s Sign

Question 37

positive and may indicate appendicitis if pain or an exaggeration sensation felt in the RLQ

Answer 37

Hypersensitivity Test

Question 38

positive if pain felt when pressure is applied under the liver border at the right costal margin (RUQ) and the client hold his /her breath (inspiratory arrest)

Answer 38

Murphy’s Sign