Abdomen Flashcards
Abdominal areas are divided into:
-4 Quadrants
-9 Regions
Regions of the Abdomen
Epigastric, R/L Hypochodriac, Umbilical, R/L Lumbar, Suprapubic/hypogastric, R/L Iliac
Common Symptoms: Abdominal
Pain, difficulty swallowing, nausea, vomitting, appetite changes, indigestion, bowel movement changes, unexplained fatigue
Xerostomia
-Dry mouth
-reduced or absent saliva flow
-can be benign
-can be a medication side effect
Dysphagia
-Problems swallowing food or liquid
-Usually caused by: GERD or neurological conditions
Varices
Dilated veins in the distal esophagus or proximal stomach
-Cause: Elevated pressure in the portal venous system
Reflux
-Regurgitation of gastric content into esophagus
-Risk factors: hiatial herna, obesity, types of food
Dyspepsia
Reoccuring discomfort or pain in the upper abdominal area
-Not an actual condition
-Indicates other conditions are occuring
Colic
Sharp localized pain that increases, peaks and subsides
-Kidney stone: Renal colic*
-Bowel obstruction
-Sometimes term applied to infants and episodes of crying
Peristalisis
Contraction and relaxation of muscle
Often refer to intestinal muscles
May also refer to other “tube
Tenesmus
-Feeling the need to pass stools
Constipation Causes
Causes include: Lifestyle factors (poor diet, dehydration), conditions (hypothyroidism, IBS, depression)
Fecal Impaction
-Lump of dry, hard stool left in the rectum associated with chronic constipation
-Common in the elderly
-Causes: chronic use of laxitives, medications, can have leakage of liquid stool around impaction
Steatorrhea
-Prescence of excess fat in feces
-Stool is: Pale/yellow in color, foul smelling, difficult to flush, may be loose
-Conditions associated: Celiac disease, gall bladder disease
Hematemesis
Vomiting of blood
-Acute bleeding: Bright red, coffe ground emesis
Melena
-Passage of dark-colored, tarry stools
-Caused by upper GI bleeding
Encopresis
Involuntary passage of bowel in children 4+
Pruritus
Itching, occurs with increased billirubin, may occur before jaundice, can occur with liver and gall bladder onditions
Calculi
Stones
Contour Types
-Flat, Rounded, Scaphoid, Distended
Scaphoid
Severe weight loss
-Seen with debilitating disease
Distention
-Protuberance
-Suprapubic bulge: Distended bladder or utuerus
Ascites
Excess fluid within the abdomen
Striae
Linear marks
-Red/blue: Weight loss
Cullen’s Sign
Bruising around umbilicus
Grey Turner’s sign
Flank bruising
AAA
Pulsation in the upper midline
Hepatic cirrhosis
Dilated veins
-Sometimes call caput medusa
Bulges, Masses and Herniations: Common Locations
Lower abdominal area (ovarian or uterine tumor)m inguinal area (herniation), diastasis recti (separation of abdominal muscles)
Normal Bowel sounds: Amount
5-34 bowel sounds/minute
Borborygmi
Loud, prolonged gurgles
Hyperactive bowel sounds: Meaning
-Suggest hyperactive peristalisis
Hypoactive bowel sounds
Decreased bowel sounds
Absence of bowel sounds
-Sign of emergency
AAA risk factors
> 65 years old, smoking, male, family hx
Friction rub
Abnormal: sound heard
-Causes liver/splenic enlargement
What happens to the veins of the abdomen when there is too much flow
Humming
Liver Span
Normal: 6-12cm
Abnormal: Suggests liver is enlarged
Spleen: Auscultation Findings
-Normal: No sound
-Abnormal: Dullness may indicate splenomegaly, solid gastric content or colon content
Murphy’s Punch Sign
-Fist Percussion to CVA of the involved side is abnormally tender compared to the other side
-Suggests inflammation or obstruction
-Pyelonephritis, Kidney stones
Types of mass in Abdomen
-Intramural Mass: More prominent/located in wall
-Intraabdominal Mass: Mass disappears/Located in abdominal cavity
Liver Palpation
-Feeling for the edge of liver
-Tenderness=Inflammation
-Blunt=Cirrhosis
Gall Bladder Palpation
-Positive Murphy’s sign (during inspiration)= Cholecystitis
Spleen Palpation
-Normal: 5% of normal adults (thin); Palpable spleen
-If palpable: Splenomegaly
Rebound tenderness
-Normal: No pain
-Abnormal: Peritoneal irritation
Rovsings Sign
-Pain at LLQ=Appendicitis
-Referred pain to the RLQ
McBurney’s Sign
Palpation in the area of appendix
Psoas/Obturator Sign
-Normal: no pain
-Abnormal: Pain to RLQ (Appendicits)
Heel-jar test
-Patient standing on toes
-Suddenly drops weight onto heels
Irritable Bowel Syndrome
-Symptoms: Repeated abdominal pain, constipation, diarrhea or both, tenesmus (urge to go to bathroom)
-Causes: Unsure
-Exams: Hyperactive/Hypoactive bowel sounds, Distension (bloating/swelling in belly area)
Inflammatory Bowel Disease: Associations
-Crohns: Chronic Severe diarrhea (distal illeum/colon)
-Ulcerative Colitis: Chronic diarrhea w/ blood or pus
-Exam: Distension, hyperactive bowel sounds, rebound tenderness
Intestinal Obstruction
-Blockage of intestines (doesn’t allow feces to pass)
-Can be partial or incomplete
-Many causes including hernia
-Complications include peritonitis
-Life threatening
Intestinal Obstruction: Exam
-Increased peristaltic waves
-Early/Partial Obstruction: Hyperactive bowel sound/high pitched sounds
-Late partial or total obstruction: Hypoactive/absent number of bowel sounds
Herniation
-Protrusion of intestinal contents (abdominal weakness)
-Acquired or congenital
-Complication includes intestinal obstruction
Areas of Hernia
Inguinal, Scars, Umbilicus
Colon Cancer
-2nd most common malignancy affecting both sexes
-May start as benign polyps
-Exam: May have occult bleeding
-Recommend screen starting at: age 45-50
Peritonitis
-Inflammation of peritoneum
-Accompanied with abdominal pain
-Localized or diffused
-Life threatening
-Exam: Decreased or absent bowel sounds, muscle rigidity
Appendicitis
-Acute condition
-Appendix becomes infected or inflammed
-Pain located in RLQ (McBurney’s Point)
-Other signs: Rosving sign, Psoas sign, Obturator sign
Hepatitis
-Inflammation of the Liver
-Acute: Caused by virus A,B,C,D,E
-Chronic: Hepatitis B and C, alcohol
Cirrhosis
-Excessive scarring with the liver
-Risk factors: excessive alcohol, other liver diseases
-Complications: Liver cancer
-Symptoms: Jaudice, pruritis, fatigue
Liver Cancer
-Primary: Begins in liver (MC type: Hepatocellular carcinoma)
-Secondary: Metastatized to liver from another source (most)
Splenomegaly
-Enlargement of the spleen
-Symptoms: Kehr’s sign*, fatigue, pain in LUQ
-Causes infections, liver disease, anemia
-Can rupture
Acute Cholecystitis
-Inflammation of gall bladder
-Common sx: right shoulder pain*
-MC cause: gall stones block cystic duct
-Risk factors (5 F’s): Female, Fertile, 40yo, Obesity (Fat), Flatuent
-Exam: Positive Murphy’s sign
GERD
-Gastrointestinal Reflux Disease
-Cardiac sphincter allows stomach contents into esophagus
-Sx: 2x/week
Peptic Ulcer
-Breakdown in lining of stomach or duodenum
-Risk factors: NSAIDS and tobacco
-Symptoms: Upper ab pain (at night or eating)
-Exam: Tenderness in local area
Nephrolithiasis
-Stones within the kidney
-MC: Consist of crystals made up of calcium oxalate or calcium phosphate
-Risk factors: Family history, 40+ yo, Male, dehydration, diet
Ureteral Colic (Renal Colic)
Waves of pain caused by kidney stone
-Pain is from sudden ureteral distention
-Felt in the flank, groin and testicle
-Pain moves as the stone moves
Urinary Tract Infection (UTI)
-Bacterial infection of the urinary tract
Pyelonephritis
-Kidney infection
-Exam: Murphy’s sign (+)
Cystitis
Bladder infection
-Exam: suprapubic bulge
Abdominal Aortic Aneurysm
-Abnormal dilation of abdominal aorta
-MC cause: artherosclerosis
-Risk factors: Smoking, hypertension, older age, male, family history
-Mostly asymptomatic
-Exam: Cullen or Grey Turner sign, visible pulsatoin in midline, bruit, width >3.0cm
