Abdomen Flashcards
8 inspection
- straie
- lesion/ rashes/ scars
- skin condition
- umbilicus
- vascularity
- contour & symmetry
- aortic pulsation
- abdominal movement
umbilicus inspection normal result
skin tone similar to surrounding skin, or even pinkish
umbilicus inspection abnormal result
inverted: umbilicu hernia
sign of infection/ discharge (esp. in newborns)
vascularity inspection normal inspection
scattered fine vessels ay be visible
vascularity inspection abnormal inspection
dilated vessels: liver cirrhosis, vascular disease, ascites
skin tone inspection normal result
paler than other part: less exposure to natural elements
skin tone inspection abnormal result
yellow: jaudance
red/ bruise: inflammation/ injuries
purple: bleeding abdominal wall
taut skin: ascites
Straie inspection normal result
new: pink bluish
old: streatch mark/ slilver
Straie inspection abnormal result
dark blue: cushing syndrome
lesion/ scar/ rash inspection normal result
none; old scar: pale & smooth
lesion/ scar/ rashes: inspection abnormal result
nonhealing wounds: deep red, irregular
changes in moles
contour & symmetry inspection normal result
flat, rounded, scaphoid (normal for thin adult)
symmetrical
contour & symmetry abnormal inspection result
scaphoid: malnutrition
distended: 6F (fat, flatulance, feaces, fluid, fribroid, fetus)
asymmetrical: organ enlargment/ lack of fatty tissue
Adominal movement inspection normal result
abdominal respiraotry movement
Adominal movement inspection abnormal result
visible peristatic wave: bowel obstruction
Aortic pulsation inspection normal result
slightly visible
may extend to full length in thin adults
Aortic pulsation inspection abnormal result
exaggerated, vigorous, broad pulsation visible: abdominal aneurysm (shall check BP of both arms immediately)
2 auscultation
- bowel sound
- vascular sound
Bowel sound auscultation normal result
5-30 intermittent positive sound
Bowel sond auscultation abnormal result
hyperactive: rushing may indicate diarrhea
hypoative: quiet & infrequent may indicate intestinal obstruction
Vescular sound auscultation normal result
no bruit/ swishing sound is heard via bell side of stethoscope
Vescular sound auscultation abnormal result
bruit (swishing) sound is heard: vascular issue (aeurysm/ renal vascular stenosis), need angiogram/ ultrasound
Percussion normal result
dullness over liver area
tympany all over abdomen due o air in the instestine
Percussion abnormal result
dullness in area other than the liver area: significant fluid/ matter exist in the intestine (fribre)
accentuated tmypany: distended abdomen
2 types of palpation in abdominal assessment
light (1-2cm) & deep max. 5cm)
perform light then deep palpation
Palpation normal result
umbilicus & surrounding area free of swelling, bulging, masses
should feel soft, non-tender without guarding
mild tender over cecum, sigmoid colo, aorta when deep palpation
palpation abnormal result
guarding: abnormal sign of abdominal wall spasm to protect abnormal organ
Gurading (obj. sign) + parietal pain (subj. sign): internal organ rupture
> need CT scan (computerized tomology)
should palpation be performed to patient with abdominal aortic aneurysm
deep palpation should not be performed
Inflammation of gallbladder: what is muphy sign
pain when pressure is applied to right costal margin area
Liver palpation technique
hooking technique performed bimanually
Liver palpation normal result
edge of the liver may be palpable in right costal margin, no enlargmenet
Spleen palpation normal result
not palpable, no enlargement
What position should be used for spleen palpation
right lateral/ side lyinh position
kidneys palpation (left & right) normal result
not palpable, no enlargement
bladder palpation normal result
empty bladder: not palpable
distended bladder: smooth & rounded
what is Rovsing sign? what does it ssuggest? what should normal result be like?
when pressure is aplied to LLQ, RLQ feels rebound pain when pressure is quickly relieved
suggest aute appendicitis
normal: no rebound pain is triggered
what is psoas sign? (when hyperextend client’s right leg, RLQ feels pain)
suugest iliopsoas irritation due to appendicitis
Obturator sign
irritation of obturator muscle due to appendicitis
TGRR stands for?
Tenderness, guarding, rebound pain, rigidity