Abdomen Flashcards
Initially periumbilical or epigastric, colicky; later becomes localized to RLQ, often at McBurneys point
Appendicitis
Onset sudden or gradual; pain generalized or localized, dull or severe and unrelenting; guarding; pain on deep inspiration
Peritonitis
Severe, unrelenting RUQ or epigastric pain; may be referred to right sub scapular area
Cholecystitis
Dramatic, sudden, excruciating LUQ, epigastric, or umbilical pain; may be present in one or both flanks; may be refereed to left shoulder and penetrates to back
Pancreatitis
Lower quadrant, worse on left
Salpingitis
Lower quadrant, increases with activity
Pelvic inflammatory disease
Epigastric, radiating down left side of abdomen especial after eating; may be referred to back
Diverticulitis
Abrupt RUQ may be referred to shoulders
Perforated gastric or duodenal ulcer
Abrupt, severe, colicky, spasmodic; referred to epigastrium, umbilicus
Intestinal obstruction
Referred to hypogastrium and umbilicus
Volvulus
Steady throbbing midline over aneurysm; may penetrate to back, flank
Leaking abdominal aneurysm
Episodic, severe, RUQ, or epigastrium lasting 15 minutes to several hours may be lower
Biliary stones, colic
Guarding, tenderness; + iliopsoas and + obturator signs, RLQ skin hyperesthesia; anorexia, nausea, or vomiting after onset of pain; low grade fever; + Aaron, Rovsing, Markle, and McBurney signs
Appendicitis
Shallow respiration; + Blumberg, Markle, and Balance signs; reduced or absent bowel sounds, nausea and vomiting; + obturator & iliopsoas signs
Peritonitis
RUQ tenderness and rigidity, + Murphy sign, palpable gallbladder, anorexia, vomiting, fever, possible jaundice
Cholecystitis
Epigastric tenderness, vomiting, fever, shock; + Gray Turner sign; + Cullen sign; both signs occur 2 to 3 days after onset
Pancreatitis
Nausea, vomiting, fever, suprapubic tenderness, rigid abdomen, pain on pelvic examination
Salpingitis
Tender adnexa and cervix, cervical discharge, dyspareunia
Pelvic inflammatory disease
Flatulence, borborygmus, diarrhea, dysuria, tenderness on palpation
Diverticulitis
Abdominal free air and distention with increased resonance over liver; tenderness in epigastrium or RUQ; rigid abdominal wall, rebound tenderness
Perforated gastric or duodenal ulcer
Distention, minimal rebound tenderness, vomiting, localized tenderness, visible peristalsis; bowel sounds absent (with paralytic obstruction) or hyperactive high pitched (with mechanical obstruction)
Intestinal obstruction
Distention, nausea, vomiting, guarding, sigmoid loop volvulus may be palpable
Volvulus
Nausea, vomiting, abdominal mass, bruit
leaking abdominal aneurysm
RUQ tenderness, soft abdominal wall, anorexia, vomiting, jaundice, subnormal temperature
Biliary stones, colic
intense; flank, extending to groin and genitals; may be episodic
renal calculi
lower quadrant; referred to shoulder; with rupture is agonizing
ectopic pregnancy
lower quadrant, steady, increases with cough or motion
ruptured ovarian cyst
intense; LUQ, radiating to left shoulder; may worsen with foot of bed elevated
splenic rupture
fever, hematuria; + Kehr sign
renal calculi
hypogastric tenderness, symptoms of pregnancy, spotting, irregular menses, soft abdominal wall, mass on bimanual pelvic examination; ruptured; shock, rigid abdominal wall, distention; + Kehr and Cullen signs
Ectopic pregnancy
Vomiting, low grade fever, anorexia, tenderness on pelvic examination
Ruptured ovarian cyst
Shock, pallor, lowered temperature
splenic rupture
Hypogastric pain; crampy, variable, infrequent associated with bowel function
irritable bowl syndrome
crampy pain after drinking milk or eating milk products
lactose intolerance
localized pain
diverticular disease
colicky or dull and steady pain that doesn’t progress or worsen
constipation
pain related to menses, intercourse
uterine fibroids
localized pain that increases with exertion or lifting
hernia
burning or gnawing pain in midepigastrium, worsens with recumbency and certain foods
esophagitis/gastroesophageal reflux disease
burning or gnawing pain
peptic ulcer
constant burning pain in epigastrium
gastritis
unremarkable physical examination. Pain associated with gas, bloating, distention; relief with passage of flatus, feces
Irritable bowel syndrome
associated with diarrhea; unremarkable physical examination
lactose intolerance
abdominal tenderness, fever
diverticular disease
fecal mass palpable myomas
uterine fibroids
hernia on physical examination
hernia
may have epigastric tenderness on palpation
peptic ulcer
May be accompanied by nausea, vomiting, diarrhea, or fever. Unremarkable physical examination
Gastritis
Burning sensation
peptic ulcer
Cramping
biliary colic, gastroenteritis
Colicky
appendicitis with impacted feces; renal stone
Aching
appendices irritation
knifelike
pancreatitis
Ripping, tearing
Aortic dissection
Gradual onset
infection
Sudden onset
duodenal ulcer, acute pancreatitis, obstruction, perforation
Duodenal ulcers, hepatitis, hepatomegaly, lower lobe pneumonia, and cholecystitis are found in what abdominal quadrant?
RUQ
Appendicitis, salpingitis, ovarian cyst, ruptured ectopic pregnancy, tube-ovarian abscess, renal/uretal stone, strangulated hernia, mocked diverticulitis, regional ileitis, and perforated cecum are found in what quadrant?
RLQ
Intestinal obstruction, acute pancreatitis, early appendicitis, mesenteric thrombosis, aortic aneurysm, and diverticulitis are found in what abdominal area?
Periumbilical
Ruptured spleen, gastric ulcer, aortic aneurysm, perforated colon, lower lobe pneumonia are found in what quadrant?
LUQ
Sigmoid diverticulitis, salpingitis, ovarian cyst, ruptured ectopic pregnancy, tube-ovarian abscess, renal/uretal stone, strangulated hernia, perforated colon, regional ileitis, ulcerative colitis
LLQ
Pain or distress occurs in are of patients heart or stomach on palpation of McBurneys point
Aaron sign
what does Aarons sign indicate
appendicitis
Fixed dullness to percussion in left flank and dullness in right flank that disappears on change of position
balance sign
what does balance sign indicate
peritoneal irritation
rebound tenderness
blumberg
what does blumbergs test indicate
peritoneal irritation and appendicitis
ecchymosis around umbilicus
hemoperitoneum; pancreatitis; ectopic pregnancy
absence of bowl sounds in RLQ
dance sign
what does dance sign indicate
intussusception
ecchymosis of flanks
grey turner sign
What does grey turner sign indicate?
hemoperitoneum, pancreatitis
Abdominal pain radiating to left shoulder
Kehr sign
what does kehr sign indicate?
spleen rupture, renal calculi, or ectopic pregnancy
patient stand with straightened knees, then raises up on toes, relaxes, and allows heels to hit floor, thus jarring body. Action will cause abdominal pain if positive
marble (heel jar) sign
what does marble (heel jar) sign indicate?
peritoneal irritation, appendicite
rebound tenderness and sharp pain when mcburnesys point is palpated
mcburney sign
what does mcburneys sign indicate?
appendicitis
abrupt cessation of inspiration on palpation of gallbladder
murphy sign
what does murphy sign indicate?
cholecystitis
pain down the medial aspect of the thigh to the knees
romberg-howship sign
what does roberg-howship sign indicate
strangulated obturator hernia
RLQ pain intensified by LLQ palpation
Rovsing sign
what does rovsing sign indicate?
peritoneal irritation and appendicitis
