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Patient Assessment > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What is in the RUQ?

A

liver, gall bladder, pylorus, duodenum, pancreas head, R kidney, hepatic flexure, ascending colon, transverse colon

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2
Q

What is in the LUQ?

A

liver left lobe, spleen, stomach, pancreas body, left kidney and adrenal gland, splenic flexure, transverse colon, descending colon

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3
Q

What is in the RLQ?

A

right kidney, cecum, appendix, ascending colon, R ovary and fallopian tube and ureter, R sperm cord, Uterus, bladder

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4
Q

What is in the LLQ?

A

left kidney, sigmoid colon, descending colon, L ovary, ureter, fallopian tube, left sperm cord, uterus, bladder

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5
Q

What is the 9 areas of the abdomen?

A 
R and L hypochondrium
Umbilical
Epigastic
Suprapubic
R and L lumbar
R and L inguinal
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6
Q

What does the alimentary tract contain?

A

mouth, esophagus, stomach, small intestine, large intestine, anus

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7
Q

What is the function of the alimentary tract?

A

ingest and digest food, absorb nutrients, electrolytes and water, excrete waste products

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8
Q

What is peristalsis under control of?

A

ANS

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9
Q

What are the functions of the liver?

A 
Metabolizes carbohydrates,
protein and fats
Bile production and secretion
Fatty acid oxidations
Vitamin and iron storage
Produces clotting factors
Produces antibodies
Conjugation and excretion 
of hormones
Detoxification
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10
Q

What does the gallbladder do?

A

bile storage

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11
Q

What does bile do?

A

maintain alkaline pH in small intestine, emulsifies fat

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12
Q

What are the exocrine gland in the pancreas made up of?

A

acinar cells - digestive

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13
Q

What are the endocrine gland in the pancreas made up of?

A

islet cells - make insulin and glucagon

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14
Q

What does the white pulp do in the spleen?

A

produce lymphocytes and monocytes

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15
Q

What does the red pulp in the spleen?

A

filtration of red blood cells

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16
Q

Where is the kidney?

A

retroperitoneal space

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17
Q

What does renin control?

A

controls aldosterone secretion

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18
Q

What does the kidney do?

A

filters blood via nephrons, renin production, EPO production, produces active form of Vit D

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19
Q

What are some common abdomen symptoms?

A 
Jaundice
Abdominal distention
Mass
Pruritus (itching)
Loss of appetite
Pain
Indigestion
Nausea and vomiting
Change in bowel movements (BM)
Rectal bleeding
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20
Q

What do you want to know about adominal pain in HPI?

A 
Character
Duration
Pattern
Frequency
Location
Distribution
Time of pain
Aggravating Factors
--Meals
--Rest
--Defecation
--Vascular disorders
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21
Q

What do you want to know about indegestion per HPI?

A 
Feeling of fullness
Heartburn
Discomfort
Excessive belching
Faltulence
Loss of appetite
Severe pain
Location
--Localize or generalized
--Radiating- arms or shoulders
Food intake
--Amount
--Type
--Timing
Date of last menstrual period
Onset
--Time of day or night
--Sudden or gradual
Relief
--Antacids
--Rest
--Activity
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22
Q

What do you want to ask about diarrhea per HPI?

A 
Character
--Watery
--Copious
--Explosive
--Color
--Presence
*****Blood 
*****Mucus
*****Undigested food
*****Oil
*****Fat
Odor
# of times/day
Assoc Sx
--Fever
--Chills
--Thirst
--Weight loss
--Abdominal pain
--Crapling
--Fecal incontinence
--Food intake
--Stressful life events
--Travel history
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23
Q

What is something you want to ask about PMH for adomen?

A

GI disorders
Abdominal/ Urinary tract injury or surgery
UTI # of episodes and treatment
Major illness
Blood transfusions
Immunizations (Hep A & B)
Cancer- colorectral, breast, ovarian, endometrial

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24
Q

What are the risk factors for colon cancer?

A 
Age >50
FH- Colon CA; adenomatous polyps
PMH- colon CA, polyps or inflammatory bowel disease
PMH- ovarian or endometrial CA
AA
Ethnic Background: Jewish, Eastern European descent
Diet: low-fiber, high in red meat/processed meat, low F&V intake
Obesity
Cigarette smoking
Lack of regular physical activity
Heavy alcohol use
Type 2 Diabetes
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25
Q

What family history do you want to illicit from pt with abdomen complaint?

A 
Cancer-
Gallbladder disease
Kidney disease
Malabsorption syndromes
Hirschsprung disease
Familial Mediterranean fever
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26
Q

What are some cancers you should ask FH about?

A

colorectal and familial colorectal cancer syndromes

Familial adenomatous polyposis, hereditary nonpolyposis colorectal CA

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27
Q

What are some malabsorption syndromes that you would like to ask FH about?

A

CF and celiacs

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28
Q

What do you need to ask for SH in abdomen?

A 
Nutrition
1st day last menstrual period
Alcohol use, Smoking, Drug use
Stressful life events/chronic daily stress
Infectious disease exposure
Trauma
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29
Q

What is the steps in physical exam?

A

Inspection –> auscultation –> percussion –> palpation

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30
Q

What are you inspecting for on abdominal exam?

A 
Surface characteristics
Skin color
Linea nigra
Scars
Venous blood flow
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31
Q

What are some unexpected findings of the skin?

A 
Cyanosis
Jaundice
Redness
Bruises
Discoloration
Striae
Skin lesions
32
Q

What is ecchymosis around umbilicus?

A

Cullen’s sign

33
Q

What is ecchymosis of the flanks?

A

Grey Turner Sign

34
Q

What is seen in pregnancy due to increased melanocyte-stimulating hormone made by placenta?

A

linea nigra

35
Q

What do you see with portal HTN in the abdomen?

A

caput medusae

36
Q

How do you describe the contour of the abdomen?

A

flat, round, scaphoid

37
Q

How do you evaluate for unseen masses?

A

pt take and breath and hold it and lifts head from table

38
Q

What is generalized distention related to?

A

obesity, enlarged organs, fluid or gas

39
Q

What does distention at upper half of abdomen indicate?

A

tumor pancreatic cyst, gastric dilation

40
Q

What does lower half of abdomen distention mean?

A

ovarian tumor, pregnancy, uterine fibroids, distended bladder

41
Q

What are the Fs of distention of abdomen?

A

fat, fluid, feces, flatus, fibroid, full bladder, false pregnancy, fatal tumor

42
Q

What is rippling across the abdomen?

A

peristalsis

43
Q

What is pulsation in the abdomen associated with ?

A

AAA

44
Q

What are prolonged gurgles of stomach, early bowel sounds?

A

borborygmi

45
Q

When is absent bowel a concern?

A

after 5 min, SURGICAL EMERGENCY

46
Q

What does increased sounds in abdomen mean?

A

gastroenteritis, early intestinal obstruction, hunger

47
Q

What does high pitched tinkling in abdomen mean?

A

increased pressure of intestinal fluid or air

48
Q

What does decreased bowel sound mean?

A

peritonitis and paralytic ileus

49
Q

What are harsh sounds reflecting turbulent blood flow, use bell of stethoscope?

A

bruits

50
Q

What is heard with increased collateral circulation btw portal and system venous system?

A

Venous hum

51
Q

What are high pitched sounds associted with respiration due to inflammation?

A

Friction rubs

52
Q

What are two organs that cause friction rubs?

A

liver and spleen

53
Q

What does percussion over air filled visceral sound like?

A

high pitched tympany

54
Q

What does base of left lung sound like to percussion?

A

medium pitch, hyper resonance

55
Q

What does lung tissue and abdomen sound like to percussion?

A

resonance, sustained note of moderate pitch

56
Q

What does solid organs sound like to percussion?

A

short, high pitched dullness

57
Q

Didn’t put slide 48 in

A

Give me a 5

58
Q

How do you check for kidney issues/pyelo?

A

CVA tenderness

59
Q

What do you need to note about masses on PE of abdomen?

A

location, size, shape, consistency, tenderness, pulsation, mobility, mvmnt w/ resp

60
Q

What is the sign for cholecystitis?

A

Murphy Sign - deep palpation at lateral border of abdominis m and pt takes a deep breath

61
Q

What is the sign for appendix?

A

McBurney Sign

62
Q

What are the two maneuvers for appendicitis?

A

obturator or psoas

63
Q

Where does spleen pain refer to?

A

Left shoulder

64
Q

What does spleen pain (over the region of spleen) called?

A

Kehr Sign

65
Q

What are the two signs for ascites?

A

shifting dullness and fluid wave

66
Q

What is the sign for peritonitis?

A

Blumberg sign - rebound tenderness

67
Q

What is the sign with abdominal pain radiating to left shoulder?

A

Kehr sign

68
Q

What is the sign for appendicitis?

A

Rovsing sign

69
Q

What are the signs of peritonitis?

A

ballance, blumberg, markle

70
Q

What is fixed dullness to percussion in left and right flank, disappears with change in position?

A

ballance

71
Q

What is pt standing, raises on toes and drop heels or jarring of the bed?

A

markle

72
Q

What causes epigastric pain?

A

cholecystitis, diverticulitis, intestinal obstruction, GERD

73
Q

What can cause generalized pain?

A

peritonitis

74
Q

What can umbilical pain be?

A

intestinal obstruction, volvulus

75
Q

What can cause pelvic pain?

A

ectopic pregnancy, pelvic inflammatory disease, ruptured ovarian cyst

76
Q

What can cause back and flank pain?

A

leading AAA, renal calculi

Patient Assessment (23 decks)

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