Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Z YEAR 2 Clinical Skills > Abdomen 2 > Flashcards

Abdomen 2 Flashcards

1
Q

How can all visceral structures in the abdominal cavity be surface marked?

A
  • anterior
  • lateral
  • posterior abdominal wall regions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What areas does the liver occupy?

A

most of the right hypochondrium and the epigastrium in the upper part of the abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is most of the liver under?

A

under cover of the ribs and costal cartilages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does the liver move with the diaphragm in respiration?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to the liver on the right side during quiet respiration?

A
  1. upper surface of the liver follows the right dome of the diaphragm and lies at the level of the 5th costal cartilage or the 4th intercostal space (just above the 5th rib) at the midclavicular line
  2. lower border of the liver closely follows the costal margin (rib cage margin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens to the liver during full inspiration?

A

anterior (lower margin) of the liver projects just beyond the costal margin on the right side but it is not sufficient enough to be readily palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What part of liver would be palpable and when?

A

only the lower edge of the liver, in some people, may become palpable in deep inspiration along the right costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why is it not possible to palpate the lower border of liver in the epigastrium?

A
  • Even though lower border of the liver crosses the epigastrium (without the cover of costal cartilages or ribs)
  • not possible to palpate the lower border of liver in this region of the abdominal wall, because of strong rectus abdominis muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

During what conditions does the liver become palpable?

A

Hepatomegaly (happens in some pathological conditions e.g. congestive heart failure, hepatitis, tumours, cirrhosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the liver palpable in these conditions?

A

ower border of the enlarged liver becomes palpable below the costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why can you usually palpate the lower border of normal healthy liver in an infant or child?

A

liver extends below the costal margin to about 1.0 - 3.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is the gallbladder not palpable?

A

because of its pliable nature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is the gallbladder palpable if it is enlarged?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where is the fungus of the gallbladder located?

A

just under the tip of the 9th costal cartilage on the right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where does the tip of the 9th costal cartilage lie on the anterior abdominal wall? What can be marked here?

A
  1. just below a point at which the lateral border of the rectus abdominis muscle intersects the costal margin in the transpyloric plane
  2. Fundus of the gallbladder can be surface marked at this position in the right hypochondriac region of the abdominal wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is any gallbladder pain a result of? Where is it referred to?

A
  1. gallstones (cholelithiasis) 2.inflammation (cholecystitis) -usually referred first to the epigastric region
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where will the gallbladder pain progress to?

A

progress of the disease and involvement of the overlying parietal peritoneum, the pain will migrate to the right hypochondriac region towards the tip of the right 9th costal cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can be elected in a patient with inflamed gallbladder?

A

Murphy’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is Murphy’s sign elicted?

A

asking the patient to breathe in whilst palpating the right subcostal area, causing pain on inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where does the spleen lie? Is it palpable?

A
  1. lies under cover of the ribs on the left hypochondrium

2. Usually not palpable even during deep inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When does the spleen become palpable?

A

has to enlarge at least 3 – 4 times before it becomes palpable below the left costal margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the three borders of the liver?

A
  1. upper border
  2. oblique border
  3. right border
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where is the upper border of the liver?

A
  1. closely follow the right dome of the diaphragm in mid inspiration is marked by a line from the right 5th rib and costal cartilage
  2. which extends across the lower end of the sternum
  3. to the left 5th intercostal space at the mid-clavicular line (point 3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is the oblique border of the liver?

A
  1. follows the right costal margin from the right mid-axillary line
  2. through the tip of right 9th costal cartilage through the tip of left 8th costal cartilage (difficult to palpate)
  3. to the left 5th intercostal space in the mid-clavicular line
25
Q

Where is the right border of the liver?

A

starts from point 4 and ascends upwards along the right margin of thoracic cage to meet on the right 5th rib at mid-clavicular plane

26
Q

Where does the gallbladder lie?

A
  • at point where the lateral border of the rectus abdominis muscle crossed the costal margin
  • also where the trans-pyloric plane intersects the midclavicular plane
27
Q

Where does the train-pyloric plane run through?

A

tips of the 9th costal cartilages

28
Q

Where does the right mid clavicular line run?

A

along the lateral border of the rectus abdominis muscle

29
Q

Where does the spleen lie?

A

along the medial surfaces of the left 9th, 10th and 11th ribs

30
Q

Where are the surface projection of the spleen mapped?

A

between the lateral borders of the left erector spinae muscles and the left mid-axillary line

31
Q

How is the spleen separated from the rib cage inside the abdominal cavity?

A

by the diaphragm and the costodiaphragmatic recess

32
Q

Where does the liver gallbladder and spleen lie inside the abdominal cavity?

A

deep to the anterior abdominal wall

33
Q

Why do you use percussion?

A

determine the extent or the size of these organs

particularly useful for the liver and spleen

34
Q

How does the liver affected by disease enlarge?

A

inferiorly from the right costal margin towards the right iliac fossa

35
Q

How do you palpate the liver?

A
  1. lay the palm of your right hand in the patient’s right iliac fossa with the lateral border of the index finger aligned parallel to the right costal margin
  2. At this position the tips of your index and middle fingers will lie parallel to the rectus sheath
  3. Apply sufficient pressure with your examining (right) hand and you will ask the patient to take slow deep breaths through the mouth
36
Q

How do you keep your hand during inspiration?

A

keep your hand still during inspiration with your lateral border of the index finger expecting to feel the liver edge as it descends with inspiration

37
Q

How do you move your hand between each breath?

A

move your hands progressively, about 1 cm at a time, towards the costal margin

38
Q

How do you describe the liver’s edge if you do feel it?

A

whether its surface is smooth or irregular, soft or hard, or there is any tenderness and pulsations

39
Q

How do you examine the gallbladder?

A

asking the patient to take a deep breath while palpating, for any tenderness, in the right upper quadrant region at the midclavicular line

40
Q

Is it possible to measure the liver span?

A

yes, by percussing on the anterior chest/abdominal wall

41
Q

Where is the upper border of the liver?

A

lies at the level of the 5th rib or 5th intercostal space in the right midclavicular line

42
Q

How do you estimate the liver span?

A
  1. ask the patient to hold the breath in full expiration and percuss downwards from the right 4th rib along the midclavicular line
  2. while carefully listening for a change in the percussion note from a resonant note over the air filled lung tissue to a dull note over the solid liver tissue
    - This indicates the position of the upper border of the liver which is usually around the 5th intercostal space
43
Q

What is the start position for palpation of liver?

A

Right iliac fossa

44
Q

What is the end position for palpation of liver?

A

Right costal margin

45
Q

What is the start position for the percussion of liver? When does the dull note start?

A

Right 4th or 5th ribs at midclavicular plane - the dulls note begins at upper border. of liver

46
Q

What is the end position of the percussion of liver? When does the dull note disappear?

A

Around right costal margin - dull note disappears at lower border of liver

47
Q

In what direction do you continue to percuss liver?

A
  1. continue to percuss inferiorly until you reach the end of liver dullness (or the beginning of the resonant note of the viscera)
  2. Usually at the right costal margin for a normal liver
  3. You will measure the distance between the upper and lower limits of the liver which is usually around 13 centimetres in a healthy adult
48
Q

Where is the spleen palpable when it is enlarged least three times its normal size?

A
  • Indicates splenomegaly

- below the left anterior costal margin

49
Q

How does the spleen enlarge?

A

inferiorly from the left costal margin across the umbilicus towards the right iliac fossa

50
Q

What does palpitation of the spleen depend on?

A

downward movement when the subject takes a deep breath

51
Q

What happens during splenic enlargement?

A
  • sharp upper border a characteristic notch will be the leading edge of the organ which your palpating finger will encounter
  • will help you to distinguish it from the lower pole of an enlarged left kidney
52
Q

What is the start position for the palpitation of the spleen?

A
  • Right iliac fossa

- Lateral border of right index finger aligned parallel to left costal margin

53
Q

What is the end position for the palpitation of the spleen?

A
  • Left costal margin

- Left hand firmly pulling left lower rubs and spleen forwards

54
Q

How do you palpate the spleen?

A
  1. lay the palm of your right hand on the abdomen well below the umbilicus near the right iliac fossa region
  2. At this position the lateral border of the index finger of your right hand will be aligned parallel to the left costal margin with the finger tips pointing medially and downwards.
  3. Apply sufficient pressure with your examining hand and you will ask the patient to take slow deep breaths through the mouth.
55
Q

How does the hand act during inspiration?

A

still during inspiration with your lateral border of the index finger expecting to feel the splenic edge as it descends with inspiration

56
Q

How does the hand act between each breath?

A

move your hands progressively, about 1 cm at a time, towards the left costal margin across the umbilicus

57
Q

How do you detect any splenic enlargement which does not cross over the costal margin?

A
  • percuss over the lowest intercostal space (10th intercostal space between 10th & 11th ribs) in the left anterior axillary line whilst the patient lies in supine position
  • You will percuss at this space both during inspiration and expiration
58
Q

What does it mean if you find the percussion note becomes dull on full inspiration?

A

suspect splenomegaly

Z YEAR 2 Clinical Skills (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions