Abdomen Flashcards
what does the ABDOMEN contain?
- all of our DIGESTIVE ORGANS;
- stomach
- SMALL & LARGE intestines
- pancreas
- liver, gb
- kidneys
- spleen
what are the IMPORTANT BLOOD VESSELS that travel through the ABDOMEN?
- the AORTA & INFERIOR VENA CAVA
what are the FOUR QUADRANTS of the ABDOMEN?
- RIGHT UPPER QUADRANT (RUQ)
- RIGHT LOWER QUADRANT (RLQ)
- LEFT LOWER QUADRANT (LLQ)
- LEFT UPPER QUADRANT (LUQ)
what are the NINE REGIONS typically used?
- EPIGASTRIC (R/L HYPOCHONDRIAC REGIONS)
- UMBILICAL (R/L LUMBAR REGIONS)
- HYPOGASTRIC/SUPRAPUBIC (R/L ILIAC/INGUINAL REGIONS)
what ORGANS are in the RUQ?
- ASCENDING & TRANSVERSE COLON
- DUODENUM
- GALLBLADDER
- HEPATIC FLEXURE OF COLON
- LIVER
- PANCREATIC HEAD
- PYLORUS
- RIGHT ADRENAL GLAND
- RIGHT KIDNEY
- RIGHT URETER
what ORGANS are in the LUQ?
- LEFT ADRENAL GLAND
- LEFT KIDNEY
- LEFT URETER
- PANCREAS, SPLEEN, STOMACH
- TRANSVERSE DESCENDING COLON
what ORGANS are in the RLQ?
- APPENDIX
- ASCENDING COLON, CECUM
- RIGHT KIDNEY
- RIGHT OVARY & TUBE
- RIGHT URETER
- RIGHT SPERMATIC CORD
what ORGANS are in the LLQ?
- LEFT KIDNEY
- LEFT OVARY & TUBE
- LEFT URETER
- LEFT SPERMATIC CORD
- DESCENDING & SIGMOID COLON
what is the ABDOMINAL VASCULATURE and its STRUCTURES?
- KIDNEYS
- AORTA
- INFERIOR VENA CAVA
- ILIAC ARTERIES/VEINS
what are some SUBJECTIVE DATA assessments for the ABDOMEN?
- appetite changes
- weight changes
- dysphagia
- N & V
- bowel habit changes
- abdominal pain
what do we do if the patient has ABDOMINAL PAIN?
- want to ask the patient the EXACT LOCATION OF THE PAIN
how can ABDOMINAL PAIN be classified as?
- VISCERAL PAIN
- PARIETAL PAIN
- REFERRED PAIN
definition of VISCERAL PAIN
- DULL + CRAMPY + SQUEEZING + ACHING PAIN
- can be either CONSTANT or INTERMITTENT
- often located over an ABDOMINAL ORGAN
definition of PARIETAL PAIN
- often from INFLAMMATION OVER THE PERITONEUM
- can be typically INTENSE, CONSTANT, and on ONE SIDE
- often is AGGRAVATED by the LOWER EXTREMITY EXTENSION, COUGHING, eliciting REBOUND TENDERNESS
definition of REFERRED PAIN
- typically is VISCERAL PAIN often felt in ANOTHER AREA of the body when a COMMON NERVE PATHWAY IS SHARED
definition of CONSTIPATION
- is known as LESS THAN 3 BOWEL MOVEMENTS PER WEEK
- often see STRAINING / HARD STOOL
- often is CAUSED BY;
diet, meds, fluid, obstruction, & narcotics
definition of DIARRHEA
- is known as MORE THAN 3-4 STOOLS/DAY
- often can be LIQUID
- is caused by MEDS, INFECTIOUS AGENTS, DISEASE PROCESS, DIET
what to REMEMBER WHILE PREPARING the PATIENT?
- want the PATIENT TO EMPTY their BLADDER
- want the PATIENT IN A SUPINE POSITION
- proper DRAPING of the patient
what is the ORDER OF ABDOMINAL ASSESSMENT?
- INSPECTION
- AUSCULTATION
- PERCUSSION
- PALPATION
** want to AUSCULTATE FIRST before palpation
what to do during INSPECTION during the abdominal physical exam?
- specific SKIN CHARACTERISTICS
- symmetry
- any presence of MASSES, HERNIA, or SEPARATION OF MUSCLES
- STRAIE or SCARS
- symmetrical breathing
what to do during AUSCULTATION during the abdominal physical exam?
- want to use DIAPHRAGM to hear BOWEL SOUNDS; bruits over aortic, renal, iliac, femoral arteries
- starting at the RLQ and GO CLOCKWISE
why do we use PERCUSSION during the abdominal assessment?
- want to hear TONE in all four quadrants
- can help to estimate SPAN OF THE LIVER
- can help to differentiate between FLUID vs. AIR
what to do during PALPATION of the abdomen?
- can do different ranges of palpation; LIGHT, MODERATE, & DEEPLY PALPATE
- important to feel for BULGES & MASSES/feel various MARGINS of the abdominal organs
- always PALPATING AREA OF PAIN LAST
what is NORMAL to hear during AUSCULTATION? how long do we hear BOWEL SOUNDS?
- documentation; NORMAL, HYPERACTIVE, HYPOACTIVE, or ABSENT
- sounds; around every 5 - 15 seconds
definition of LOUD PROLONGED GURGLES
known as BORBORYGMI
- stomach growling
definition of INCREASED BOWEL SOUNDS
can be an INDICATION of;
- GASTROENTERITIS
- INTESTINAL OBSTRUCTION
- HUNGER
definition of HIGH-PITCHED TINKLING
can be an INDICATION of;
- INTESTINAL FLUID
- AIR UNDER PRESSURE (OBSTRUCTION)
definition of DECREASED BOWEL SOUNDS
can be an INDICATION of;
- PERITONITIS
- PARALYTIC ILEUS
definition of ABSENT BOWEL SOUNDS
can be an INDICATION of;
- ABDOMINAL PAIN/RIGIDITY
- SURGICAL EMERGENCY
bruit
listened with the BELL of the stethoscope
- HARSH/MUSICAL INTERMITTENT SOUND
what is the AVERAGE LIVER SPAN?
6 - 12 cm (2.5 - 4.5 inches)
other tips to REMEMBER during PERCUSSION
- tympany; AIR
- dullness; ORGANS or MASSES
** DO NOT PERCUSS SPLEEN IF THERE IS A SPLEEN INURY - can RUPTURE
definition of GASTROESOPHAGEAL REFLUX DISEASE
backward flow of gastric contents–typically acidic into the esophagus
definition of IRRITABLE BOWEL SYNDROME
a type of FUNCTIONAL CHRONIC GI DISORDER with symptoms of pain & change in STOOLING PATTERN
definition of PEPTIC ULCER DISEASE
- the presence of HELICOBACTER PYLORI
- often caused by either EXCESSIVE ALCOHOL INTAKE or NSAIDS/SMOKING
definition of HEPATITIS
type of INFLAMMATORY PROCESS characterized by DIFFUSE or PATCHY HEPATOCELLULAR NECROSIS
definition of CHOLELITHIASIS
type of STONE FORMATION in the GALLBLADDER–often due to HIGH CONCENTRATION OF BILE and produce CRYSTALS
definition of CHOLECYSTITIS
type of INFLAMMATORY PROCESS of the GALLBLADDER
- often due to OBSTRUCTION OF THE CYSTIC DUCT from CHOLELITHIASIS
what are the SIGNS & SYMPTOMS of CHOLECYSTITIS?
- have SEVERE PAIN in the RUQ
- often can see N &V, LOSS OF APPETITE, FEVER
- can also see TENDERNESS in the abdomen
- want to look for any DISTENSION or STIFFNESS on the right side–often can see LOSS OF BREATHING with palpation on the right side
appendicitis
the INFLAMMATION of the appendix
signs and symptoms of APPENDICITIS
- have SEVERE PAIN in the RLQ
- SWELLING + LOSS OF APPETITE
- N & V
- constipation or diarrhea
- fever/inability to pass gas
aortic aneurysm
type of BALLOON-LIKE BULDGES found in the AORTA
- often can palpate or see PULSATION or THROBBING on affected area around the stomach
- SOB
- pain in chest or abdomen area
- swelling in the upper portion or extremities
definition of ASCITES
ABDOMINAL SWELLING due to the ACCUMULATION of FREE FLUID in the peritoneal cavity
ascites signs and symptoms
- distended abdomen
- a PROTRUDING or displaced ABDOMEN
- BULGING FLANKS
- dyspnea
- sudden weight gain
- abdominal pain
