Abdomen

Question 1

For inspection of the abdomen, what 3 things are you looking at?

Answer 1

Skin, contours (flat, scaphoid, rounded, protuberant), umbilicus (inverted, everted, bulging)

Question 2

What is cullen’s sign? What is is consistent with?

Answer 2

ecchymosis around umbilicus, c/w pancreatitis

Question 3

What is Grey Turner’s sign? What is it c/w?

Answer 3

ecchymosis of flanks, c/w pancreatitis

Question 4

What is caput medusae? What is it c/w?

Answer 4

varicose veins around umbilicus, portal hypertension

Question 5

What are the 8 F’s for abdominal distension upon inspection?

Answer 5

fat, fetus, flatus, feces, fluid, fibroid, full bladder, fatal tumor

Question 6

What 3 types of sounds are we listening for on the abdomen?

Answer 6

bowel sounds, bruits, friction rubs

Question 7

What is succussion splash suggestive of?

Answer 7

gastric outlet obstruction

Question 8

What is a venous hum?

Answer 8

constant ‘white’ noise suggestive of portal htn

Question 9

What is a hepatic or arterial bruit?

Answer 9

systolic pulsating sounds, hepatic bruit is c/w liver cancer

Question 10

What do tympany and dullness suggest is in the abdominal cavity where you are percussing?

Answer 10

tympany = gas, dullness = fluid or solid

Question 11

What is a normal liver span at the midclavicular line? and at the midsternal line?

Answer 11

6-12cm at midclavicular, 4-8cm at midsternum

Question 12

Where do you percuss for the splenic percussion sign?

Answer 12

anterior midaxillary line, 9th rib space

Question 13

What is light palpation used to detect? deep palpation?

Answer 13

light = deliniate tenderness, deep = detect abdominal massess and enlarged organs

Question 14

What is guarding v rigidity?

Answer 14

guarding = voluntary contraction of abdominal wall.
rigidity = involuntary reflex contraction of abd wall

Question 15

What 3 special maneuvers are done for ascites?

Answer 15

shifting dullness, fluid wave, ballottement

Question 16

What 4 special maneuvers are done for appendicitis?

Answer 16

psoas sign, obturator sign, rovsina’s sign, cutaneous hyperesthesia

Question 17

What 2 special maneuver’s are done for gallbladder disease?

Answer 17

murphy’s sign, courvoisier’s sign

Question 18

What often obstructs the appendix?

Answer 18

fecalith

Question 19

What are the predictable stages of appendicitis PAIN presentation?

Answer 19

peri-umbilical pain, then pain migrates to RLQ, then nearly constant pain, then it can rupture

Question 20

With appendicitis, is the region normally tender on palpation or with rebound tenderness?

Answer 20

rebound tenderness

Question 21

What is rovsing’s sign for appendicitis?

Answer 21

RLQ pain, worsened with LLQ palpation

Question 22

What is murphy’s sign?

Answer 22

inspiratory arrest on deep palpation of the gallbladder

Question 23

What is courvoisier’s sign?

Answer 23

painless, palpable, dilated gallbladder in a pt with jaundice, suggests neoplasm of biliary tree

Question 24

What are peritoneal signs?

Answer 24

sick-appearing, diffuse abdominal tenderness, firm and rigid abdomen, absent bowel signs