Abdomen Flashcards
Which quadrant is the liver and gallbladder in?
RUQ
Which quadrant is the left lobe of the liver in?
LUQ
Which quadrant is the lower pole of the right kidney in?
RLQ
Which quadrant is the cecum and appendix in?
RLQ
Which quadrant is the lower pole of the left kidney?
LLQ
Which quadrant is the pylorus in?
RUQ
Which quadrant is the spleen in?
LUQ
Which quadrant is the stomach in?
LUQ
Which quadrant is the duodenum in?
RUQ
Which quadrant is the bladder in (if distended)?
BLQ
Which quadrant are the ovaries located in?
BLQ
Which quadrant is the uterus located in?
BLQ
Which quadrant are the ureters in?
BLQ (for each side)
Which quadrant is the splenic flexure in?
LUQ
Which quadrant are the adrenal glands located in?
BUQ
Which quadrant is the Hepatic flexure of the colon located in?
RUQ
Which quadrant is pancreas in?
LUQ
Which quadrant is the ascending colon in?
RLQ and RUQ
Which quadrant is the spermatic cords in?
RLQ and LLQ
What are the steps of the PE for the abdomen?
Look, listen, Feel
What is Grey Turner’s sign and what seen in (4)?
Bruising of the flanks
Pancreatitis
Abdominal trauma
AAA
Ruptured ectopic
What is Cullen’s sign, and what is it seen in (2)?
Periumbilical bruising
Pancreatitis
Rupture ectopic
True or false: cullen’s and grey-Turner’s sign have a high specificity, but low sensitivity?
False, low sensitivity and low specificity
What is linea nigra?
A vertical line of pigmentation down from the umbilical that is often seen in pregnancy
What is caput Medusa?
Dilated, tortuous, and superficial veins that radiate upward from the umbilicus
What is diastasis recti?
A separation between the left and right side of the retus abdominus muscle
What does a scaphoid abdomen look like?
Concave
What does a protuberant abdomen look like
Convex
What can cause a distended lower abdomen (4)?
Bladder distention
Pregnancy
Ovarian mass
Sigmoid tumor
What can cause a protuberant abdomen (4)?
Excess gas
Ascities
Organomegally
Obesity
What are you listening for when you listen to the abdomen?
Bowel sounds, bruits
Which part of the stethoscope do you listen with when auscultating the abdomen?
Diaphragm
What should you listen for in the abdomen besides bowel sounds?
Aortic bruit
Renal arteries
Iliac arteries
Femoral bruit
What is the medical terms for a stomach growling?
Borborygmi
How often do borborygmi occur?
5-35 per minute
Increased BS is indicative of what? (3)
Gastroenterisis
early obstruction
Hunger
High-pitching tinkling in the abdomen is indicative of what (2)?
Intestinal fluid and air under pressure
Early obstruction
Decreased BS is indicative of what?
Peritonisis and paralytic ileus
True or false: a healthy spleen will be dull to percussion
True
What type of sound is produced from a protuberant abdomen? What does this suggest?
Diffusely tympanitic
Intestinal obstruction
Describe tympany (pitch, resonance etc). Where is it heard?
Musical note of higher pitch than resonance
Heard over air-filler viscera
Describe hyperresonance. Where is it heard?
Between tympany and resonance.
Heard over the base of the lung.
Describe resonance. Where is it heard?
Sustained note of moderate pitch.
Heard over lung tissue and sometimes in the abdomen
Describe dullness. Where is it heard?
Short, high pitched note with little resonance
Heard over solid organs adjacent to air filler structures
What does the fluid wave test for?
Ascities
What does the shifting dullness test, test for?
Ascities
What is Lloyd’s test?
CVA TTP
True or false: a normal liver can be palpated
True
True or false: a normal kidney can be palpated
false
True or false: a normal spleen can be palpated
False
True or false: a normal aorta can be palpated
True if patient is skinny
What is an inflammation of the peritoneum?
Peritonitis
Is guarding voluntary or involuntary?
Voluntary
Where is McBurney’ point located?
1/3 distance from ASIS to umbilicus
Is rigidity voluntary or involuntary?
Involuntary
What is Rovsing’s sign?
RLQ pain worse by palpation of the LLQ. Seen in appy
What is romberg-Howship’s sign?
Pain over the medial aspect of the thigh to the knee.
Seen in stragulated obturator hernia
What is Markle’s sign?
Pain with hitting heels or jarring the abdomen
Can be seen in peritonitis, appy)
What is Kehr’s sign?
Abdominal pain radiation to the left shoulder
Spleen rupture, renal calculi, ectopic)
What is the dance sign?
Absence of bowel sounds in RLQ (intussusception)
What is Blumberg’s sign?
Fixed dullner to prescussion in the let flanks and dullness in the right flank that disappears with position change
This can be seen in peritoneal irritation or appy
Classically, burning pain is seen in what?
Peptic ulcer
Classically, cramping pain is seen in what?
biliary colic
gastroenteritis
Classically, colicky pain is seen in what?
Appy/renal stone
Classically, aching pain is seen in what?
appendiceal irritation
Classically, knife-like pain is seen in what?
Pancreatitis
Classically, ripping or tearing pain is seen in what?
Aortic dissection
Classically, a gradual pain is seen in what?
infx
Classically, sudden pain is seen in what?
duodeanal ulcer
Acute pancreatitis
obstruction/perforation
Sudden LUQ/epigastric pain that radiates to the left shoulder. Associated symptoms include vomiting, fever, and shock. PE shows +grey turner’s and Cullen signs. Diagnosis?
Pancreatitis
LLQ pain with associated fever, diarrhea, anorexia. LLQ TTP. Diagnosis?
Diverticulitis
BLQ pain in sexually active female. Associated n/v cervical discharge, dyspareunia. Adnexal and cervical TTP. Diagnosis?
PID
Above what age is considered a risk for colon CA?
older than 50
What ethnic background is predisposed to colon CA?
Jew
True or false:obesity increases the risk for colon CA
True
True or false: smoking increases the risk for colon CA
True
True or false: EtOH increases the risk for colon CA
True
What type of diet predisposes people to colon CA?
low fiber/fruit/veggies
High fat
What are the two major hereditary diseases that cause colon CA?
HNPCC
FAP
True or false: you should try to avoid examining babies in their mother’s arm/lap
False, opposite is true
True or false: diastasis recti is benign in children and will resolve itself
True
What are the aggrevating factors for an umbilical hernia in infants?
Crying, straining etc
True or false: umbilical hernias in infants are benign and will usually close by themselves
True
True or false: inguinal hernias in infants are benign and will usually close by themselves
False–inguinal hernias may incarcerate
Are infants’ abdomen more rounded or more flat than adults?
Rounded
True or false: distension of an infants abdomen is normal, but scaphoid abdomens are abnormal
False, both abnormal
When do umbilical cord fall off generally?
14 days
Why should you not do a toddler’s abdominal exam standing up?
Their stomach will appear distended d/t lumbar lordosis
How many cm below the costal margin will you find infant’s livers? Where should you start then?
1-3 cm below, so start 3-4 cm below
Is it okay to palpate a baby’s abdomen while they’re breast feeding?
Yes, encouraged for calmness
Why do you flex infants knees when palpating their abdomen?
softens stomach
What is the most common palpable mass in an infant’s abdomen?
Enlarged kidney
Redness around the umbilical cord is concerning for?what
Necratizing fasicitis