Abdomen Flashcards
For inspection of the abdomen, what 3 things are you looking at?
Skin, contours (flat, scaphoid, rounded, protuberant), umbilicus (inverted, everted, bulging)
What is cullen’s sign? What is is consistent with?
ecchymosis around umbilicus, c/w pancreatitis
What is Grey Turner’s sign? What is it c/w?
ecchymosis of flanks, c/w pancreatitis
What is caput medusae? What is it c/w?
varicose veins around umbilicus, portal hypertension
What are the 8 F’s for abdominal distension upon inspection?
fat, fetus, flatus, feces, fluid, fibroid, full bladder, fatal tumor
What 3 types of sounds are we listening for on the abdomen?
bowel sounds, bruits, friction rubs
What is succussion splash suggestive of?
gastric outlet obstruction
What is a venous hum?
constant ‘white’ noise suggestive of portal htn
What is a hepatic or arterial bruit?
systolic pulsating sounds, hepatic bruit is c/w liver cancer
What do tympany and dullness suggest is in the abdominal cavity where you are percussing?
tympany = gas, dullness = fluid or solid
What is a normal liver span at the midclavicular line? and at the midsternal line?
6-12cm at midclavicular, 4-8cm at midsternum
Where do you percuss for the splenic percussion sign?
anterior midaxillary line, 9th rib space
What is light palpation used to detect? deep palpation?
light = deliniate tenderness, deep = detect abdominal massess and enlarged organs
What is guarding v rigidity?
guarding = voluntary contraction of abdominal wall.
rigidity = involuntary reflex contraction of abd wall
What 3 special maneuvers are done for ascites?
shifting dullness, fluid wave, ballottement
What 4 special maneuvers are done for appendicitis?
psoas sign, obturator sign, rovsina’s sign, cutaneous hyperesthesia
What 2 special maneuver’s are done for gallbladder disease?
murphy’s sign, courvoisier’s sign
What often obstructs the appendix?
fecalith
What are the predictable stages of appendicitis PAIN presentation?
peri-umbilical pain, then pain migrates to RLQ, then nearly constant pain, then it can rupture
With appendicitis, is the region normally tender on palpation or with rebound tenderness?
rebound tenderness
What is rovsing’s sign for appendicitis?
RLQ pain, worsened with LLQ palpation
What is murphy’s sign?
inspiratory arrest on deep palpation of the gallbladder
What is courvoisier’s sign?
painless, palpable, dilated gallbladder in a pt with jaundice, suggests neoplasm of biliary tree
What are peritoneal signs?
sick-appearing, diffuse abdominal tenderness, firm and rigid abdomen, absent bowel signs
