Abdomen Flashcards
Abdomen
,
STRUCTURE AND FUNCTION
,
SURFACE LANDMARKS
,
The abdomen is a large, oval cavity extending from the diaphragm down to the brim of the pelvis. It is bordered in back by the vertebral column and paravertebral muscles and at the sides and front by the lower rib cage and abdominal muscles.
A)true
B)false
A
The ________ is a large, oval cavity extending from the diaphragm down to the brim of the pelvis. It is bordered in back by the vertebral column and paravertebral muscles and at the sides and front by the lower rib cage and abdominal muscles
abdomen
________It is bordered in back by the vertebral column and paravertebral muscles and at the sides and front by the lower rib cage and abdominal muscles.
The abdomen
The abdomen is a large, oval cavity extending from the diaphragm down to the brim of the pelvis.
A)true
B)false
A
Four layers of large, flat muscles form the ventral abdominal wall, are joined at the midline by a tendinous seam, the linea alba.
A)true
B)false
A
Four layers of large, flat muscles form the ventral abdominal wall.
A)true
B)false
A
___________ are joined at the midline by a tendinous seam, the linea alba..
Four layers of large, flat muscles form the ventral abdominal wall
Four layers of large, flat muscles form the________ abdominal wall. These are joined at the midline by a tendinous seam, the linea alba
ventral
INTERNAL ANATOMY
,
Inside the abdominal cavity, all the internal organs are called the viscera.
A)true
B)false
A
all the internal organs in the Inside the abdominal cavity,are called the viscera
A)true
B)false
A
The solid viscera are those that maintain a characteristic shape (liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus).
A)true
B)false
A
solid viscera maintain a characteristic shape (liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus).
A)true
B)false
A
liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus. Area
The solid viscera those that maintain a characteristic shape.
The liver fills most of the right upper quadrant (RUQ) and extends over to the left midclavicular line. The lower edge of the liver and the right kidney normally may be palpable.
A)true
B) false
A
The _______ fills most of the right upper quadrant (RUQ) and extends over to the left midclavicular line.
liver
The lower edge of the liver and the right kidney normally may be palpable
A)true
B)false
A
The ovaries normally are palpable only on bimanual examination during the pelvic examination.
A)true
B)false
A
The _________ normally are palpable only on bimanual examination during the pelvic examination.
ovaries
The shape of the hollow viscera (stomach, gallbladder, small intestine, colon, and bladder) depends on the contents.
A)true
B)false
A
The shape of the hollow viscera depends on the contents.
A) true
B)false
A
stomach, gallbladder, small intestine, colon, and bladder. Are
The shape of the hollow viscera (stomach, gallbladder, small intestine, colon, and bladder) depends on the contents.
They usually are not palpable, although you may feel a colon distended with feces or a bladder distended with urine.
A) true
B) false
A
Hollow viscera are usually not palpable, although you may feel a colon distended with feces or a bladder distended with urine.
A) true
B) false
A
The stomach is just below the diaphragm, between the liver and spleen. The gallbladder rests under the posterior surface of the liver, just lateral to the right midclavicular line.
A)true
B)false
A
The ________ is just below the diaphragm, between the liver and spleen.
stomach
The ________ rests under the posterior surface of the liver, just lateral to the right midclavicular line.
gallbladder
small intestine is located in all four quadrants.
A)true
B)false
A
It extends from the stomach’s pyloric valve to the ileocecal valve in the right lower quadrant (RLQ), where it joins the colon
Small intestine
The spleen is a soft mass of lymphatic tissue on the posterolateral wall of the abdominal cavity, immediately under the diaphragm. It lies obliquely with its long axis behind and parallel to the tenth rib, lateral to the midaxillary line. Its width extends from the ninth to the eleventh rib,about 7 cm
A)true
B)false
A
The _______ is a soft mass of lymphatic tissue on the posterolateral wall of the abdominal cavity, immediately under the diaphragm. It lies obliquely with its long axis behind and parallel to the tenth rib, lateral to the midaxillary line. Its width extends from the ninth to the eleventh rib,about 7 cm
spleen
It is not palpable normally. If it becomes enlarged, its lower pole moves downward and toward the midline.
Spleen
The spleen is not palpable normally. If it becomes enlarged, its lower pole moves downward and toward the midline.
A)true
B)false
A
The aorta is just to the left of midline in the upper part of the abdomen. It descends behind the peritoneum, and at 2 cm below the umbilicus, it bifurcates into the right and left common iliac arteries opposite the fourth lumbar vertebra.
A)true
B)false
A
The ______ is just to the left of midline in the upper part of the abdomen. It descends behind the peritoneum, and at 2 cm below the umbilicus, it bifurcates into the right and left common iliac arteries opposite the fourth lumbar vertebra.
aorta
You can palpate the aortic pulsations easily in the upper anterior abdominal wall. The right and left iliac arteries become the femoral arteries in the groin area. Their pulsations are easily palpated as well, at a point halfway between the anterior superior iliac spine and the symphysis pubis.
A)true
B)false
A
You can palpate the aortic pulsations in the upper anterior abdominal wall.
A)true
B)false
A
The right and left iliac arteries become the femoral arteries in the groin area. Their pulsations are easily palpated as well, at a point halfway between the anterior superior iliac spine and the symphysis pubis.
A)true
B)false
A
The right and left iliac arteries become the __________ in the groin area. Their pulsations are easily palpated as well, at a point halfway between the anterior superior iliac spine and the symphysis pubis.
femoral arteries
The pancreas is a soft, lobulated gland located behind the stomach. It stretches obliquely across the posterior abdominal wall to the left upper quadrant.
A)true
B)false
A
The ________ is a soft, lobulated gland located behind the stomach. It stretches obliquely across the posterior abdominal wall to the left upper quadrant
pancreas
The bean-shaped kidneys are retroperitoneal, or posterior to the abdominal contents. They are well protected by the posterior ribs and musculature.
A)true
B)false
A
The bean-shaped ________ are retroperitoneal, or posterior to the abdominal contents. They are well protected by the posterior ribs and musculature
kidneys
The bean-shaped kidneys are located retroperitoneal, They are well protected by the posterior ribs and musculature.
A)true
B) false
A
The twelfth rib forms an angle with the vertebral column, the costovertebral angle.CVA
A)true
B)false
A
The left kidney lies here at the eleventh and twelfth ribs. Because of the placement of the liver, the right kidney rests 1 to 2 cm lower than the left kidney and sometimes may be palpable.
A)true
B)false
A
The left kidney lies at the eleventh and twelfth ribs.
A)true
B)false
A
Because of the placement of the liver, the right kidney rests 1 to 2 cm lower than the left kidney and sometimes may be palpable.
A)true
B)false
A
sometimes the right kidney may be palpable.
It lies 1-2 cm lower than the left because of the liver
A)true
B)false
A
For convenience in description, the abdominal wall is divided into four quadrants by a vertical and a horizontal line bisecting the umbilicus .
A)true
B)false
A
epigastric for the area between the costal margins.
A)true
B)false
A
Area above the costal margins is called epigastric
A)true
B)false
A
hypogastric or suprapubic for the area above the pubic bone.
A)true
B)false
A
The anatomic location of the organs by quadrants is as follows:
,
Liver Gallbladder Duodenum Head of pancreas Right kidney and adrenal Hepatic flexure of colon Part of ascending and transverse colon Is located at
RIGHT UPPER QUADRANT (RUQ)
Stomach Spleen Left lobe of liver Body of pancreas Left kidney and adrenal Splenic flexure of colon Part of transverse and descending colon Are located what body region
LEFT UPPER QUADRANT (LUQ
Part of descending colon Sigmoid colon Left ovary and tube Left ureter Left spermatic cord Are located what region of the body
LEFT LOWER QUADRANT (LLQ
Cecum Appendix Right ovary and tube Right ureter Right spermatic cord Are located what region of the body
RIGHT LOWER QUADRANT (RLQ)
Aorta
Uterus (if enlarged)
Bladder (if distended)
Are located what region of the body
Bladder (if distended)
DEVELOPMENTAL COMPETENCE
Infants and Children
,
In the newborn, the umbilical cord shows prominently on the abdomen. It contains two arteries and one vein.
A) true
B)false
A
umbilical cord on a newborn shows prominently, it contains two artifices and one vein.
A)true
B)false
A
The liver takes up proportionately more space in the abdomen at birth than in later life. In healthy term neonates, the lower edge may be palpated 0.5 to 2.5 cm below the right costal margin.
A) infants
B)adult
A
The liver takes up proportionately more space in the abdomen at birth than in later life. In healthy neonates, the lower edge of the liver may be palpated 0.5 to 2.5 cm below the right costal margin.
A)infants
B)adult
A
The urinary bladder is located higher in the abdomen than in the adult. It lies between the symphysis and the umbilicus. Also, during early childhood, the abdominal wall is less muscular, so the organs may be easier to palpate.
A) true
B) false
A
The urinary bladder is located higher in the abdomen of an infant. It lies between the symphysis and the umbilicus.
A)true, infant
B)false,infant
A
during early childhood, abdominal wall is less muscular, so its easier to palpate the organs.
A)true
B)false
A
DEVELOPMENTAL COMPETENCE
The Pregnant Woman
,
Nausea and vomiting, or “morning sickness:’ is an early sign of pregnancy for most pregnant women, starting between the first and second missed periods. The cause is unknown but may be due to hormone changes such as the production of human chorionic gonadotropin (hCG).
A)true
B)false
A
Nausea and vomiting, or “morning sickness” is an early sign of pregnancy, starting between the first and second missed periods.
A)true
B)false
A
Nausea and vomiting, of early pregnancy is also called .
Morning sickness
Another symptom is “acid indigestion” or heartburn (pyrosis) caused by esophageal reflux.
A)pregnant woman
B)adult
A
Gastrointestinal motility decreases, which prolongs gastric emptying time. The decreased motility causes more water to be reabsorbed from the colon, which leads to constipation.
A)pregnant woman true
B)false
A
The constipation, as well as increased venous pressure in the lower pelvis, may lead to hemorrhoids in an pregnant woman
A)true
B)false
A
The enlarging uterus displaces the intestines upward and posteriorly. Bowel sounds are diminished.
A)true pregnant woman
B)false
A
The intestines in an pregnant woman is located upward and posteriorly. And bowel sounds are diminished also
A)true
B)false
A
Traditional thinking was that the appendix was displaced upward and to the right. But the appendix does not move.
A)true
B)false
A
clinical evidence has have shown that pregnancy does not change the location of the appendix.
A)true
B)false
A
Any appendicitis-related pain during pregnancy would still be felt in the right lower quadrant.
A)true
B)false
A
skin changes on the abdomen, such as striae and linea nigra are present doing pregnancy
A)true
B)false
A
DEVELOPMENTAL COMPETENCE
The Aging Adult
,
Aging alters the appearance of the abdominal wall.
A)true
B)false
A
During and after middle age, some fat accumulates in the suprapubic area in females as a result of decreased estrogen levels.
A)true
B)false
A
as a result of decreased estrogen levels, some fat accumulates in the suprapubic area in females as a result of decreased estrogen levels.
A)true
B)false
A
Males also show some fat deposits in the abdominal area, resulting in the “big belly.” This accentuates in adults with a more sedentary lifestyle.
A) true
B)false
A
Aging adults with sedentary lifestyle. Males show some fat deposits in the abdominal area, resulting in the “big belly.”
A) true
B)false
A
With further aging, adipose tissue is redistributed away from the face and extremities and to the abdomen and hips. The abdominal musculature relaxes.
A) true
B)false
A
In the aging adult fat in accumulated in the abdomen and in the hips. And also the abdominal muscles are relax.
A)true
B)false
A
Changes of aging occur in the gastrointestinal system but do not significantly affect function as long as no disease is present.
A)true
B)false
A
No great changes occur in the GI in aging adults unless, disease is present
A)true
B)false
A
Salivation decreases in aging adult causing a dry mouth and a decreased sense of taste.
A)true
B)false
A
Esophageal emptying is delayed. If an aging person is fed in the supine position, this increases risk for aspiration.
A)true
B)false
A
Esophageal emptying is delayed. So do not feed the patient in the supine position, because of increase risk of aspiration.
A)aging adult
B) false
A
Gastric acid secretion decreases with aging. This may cause pernicious anemia (because it interferes with vitamin B12 absorption), iron deficiency anemia, and malabsorption of calcium.
A)true
B)false
A
Gastric acid secretion decreases with aging. This may cause pernicious anemia, iron deficiency anemia, and malabsorption of calcium.
A)true
B)false
A
The incidence of gallstones increases with age, occurring in 10% -20% of middle-aged and older adults, being more common in females.
A) true
B)false
A
gallstones increases with age, occurring in 10% -20% of middle-aged and older adults, being more common in females.
A) true
B)false
A
Liver size decreases by 25% between the ages of 20 and 70 years, although most liver function remains normal.
A)true
B)false
A
Drug metabolism by the liver is impaired, in part because by age 65, blood flow through the liver is decreased by 33%. Therefore the liver metabolism that is responsible for the enzymatic oxidation, reduction, and hydrolysis of drugs is substantially decreased with age.
A)true
B)false
A
Prolonged liver metabolism causes increased side effects (e.g., older people taking benzodiazepines scored lower on functional status measures and had increased risk for hip fracture).
A)true, aging adult
B)false
A
enzymatic oxidation, reduction, and hydrolysis of drugs is substantially decreased with an aging adult.
A)true
B)false
A
Aging persons frequently report constipation; most prevalence estimates are between 12% and 19%.
A)true, aging adult
B)false,aging adult
A
Because there is confusion as to what defines constipation, the Rome criteria have been developed as standardized symptom criteria. These symptoms include reduced stool frequency (less than 3 bowel movements per week), as well as other common and troubling associated symptoms (i.e., straining, lumpy or hard stool, feeling of incomplete evacuation, feeling of anorectal blockage, use of manual maneuvers).
A)true, aging adult
B)false, aging adult
A
Rome criteria have been developed as standardized symptom criteria for constipation. These symptoms include reduced stool frequency (less than 3 bowel movements per week), as well as other common and troubling associated symptoms (i.e., straining, lumpy or hard stool, feeling of incomplete evacuation, feeling of anorectal blockage, use of manual maneuvers).
A)true
B)false
A
symptoms of ___________include reduced stool frequency (less than 3 bowel movements per week), as well as other common and troubling associated symptoms (i.e., straining, lumpy or hard stool, feeling of incomplete evacuation, feeling of anorectal blockage, use of manual maneuvers).
Constipation
Common causes of constipation include decreased physical activity, inadequate intake of water, a low-fiber diet, side effects of medications (opioids, tricyclic antidepressants), irritable bowel syndrome, bowel obstruction, hypothyroidism, and inadequate toilet facilities (i.e., difficulty ambulating to the toilet may cause the person to deliberately retain the stool until it becomes hard and difficult to pass).
A)true for aging adults
B)false for aging adults
A
Common causes of constipation include decreased physical activity, inadequate intake of water, a low-fiber diet, side effects of medications, irritable bowel syndrome, bowel obstruction, hypothyroidism, and inadequate toilet facilities.
A)true
B)false
A
CULTURE AND GENETICS
,
Lactase is the digestive enzyme necessary for absorption of the carbohydrate lactose (milk sugar).
A)true
B)false
A
In some racial groups, lactase activity is high at birth but declines to low levels by adulthood. These people are lactose intolerant and have abdominal pain, bloating, and flatulence when milk products are consumed.
A)true
B)fase
A
lactose intolerant people may experience abdominal pain, bloating, and flatulence when milk products are consumed.
A) true
B)false
A
In some racial groups, lactase activity is high at birth but declines to low levels by adulthood. These people are lactose intolerant and have abdominal pain, bloating, and flatulence when milk products are consumed
Millions of American adults have the potential
for lactose-intolerance symptoms, and traditional estimated rates were that 15% of whites, 50% of Mexican Americans,
and 80% of African Americans had the condition.
A)true
B)false
A
Lactose insolence is at risk for crucial nutrients because dairy foods meet crucial nutritional requirements including calcium, magnesium, and potassium.
A)true
B)false
A
Obesity is the accumulation of excess body fat.
A)true
B)false
A
Obesity is caused by a complex interaction of genetic predisposition, dietary intake, physical inactivity, and what is now called an “obesogenic” environment (one that encourages large portions of high-fat, energy-dense food)
A)true
B)false
A
Among children, Mexican-American boys had a greater prevalence of overweight than had white or Black boys.
A)true
B)false
A
Mexican-American and Black girls were significantly more likely to be overweight than white girls.
A)true
B)false
A
No differences were found in overweight rates in men of various racial groups.
A)true
B)false
A
in adult women, Mexican Americans and African Americans were significantly more likely to be obese than were whites.
A)true
B)false
A
Obesity in adults results in comorbidities of type 2 diabetes and cardiovascular disease.
A)true
B)false
A
Obese children have an increased risk for asthma, diabetes, liver disease, cardiovascular disease, sleep apnea, and joint problems, and they risk becoming obese adults.
A)true
B) false
A
SUBJECTIVE DATA
,
- Appetite
- Dysphagia
- Food intolerance
- Abdominal pain
- Nausea/vomiting
- Bowel habits
A)subjective data
B)objective data
A
Appetite
,
Any change in appetite? Is this a loss of appetite? Any change in weight? How much weight gained or lost? Over what time period? Is the weight loss due to diet?
A)Anorexia is a loss of appetite from gastrointestinal (GI) disease, as a side effect to some medications, with pregnancy, or with psychological disorders.
B)false
A
________is a loss of appetite from gastrointestinal (GI) disease, as a side effect to some medications, with pregnancy, or with psychological disorders.
Anorexia
Dysphagia
,
Dysphagia. • Any difficulty swallowing? When did you first notice this?
A)Dysphagia occurs with disorders of the throat or esophagus.
B)false
A
________occurs with disorders of the throat or esophagus.
Dysphagia
Food Intolerance
,
Food intolerance. • Are there any foods you cannot eat? What happens if you do eat tl1em: allergic reaction, heartburn, belching, bloating, indigestion?
A)Food intolerance (e.g., lactase deficiency resulting in bloating or excessive gas after taking milk products)
B)false
A
Food intolerance can be lactase deficiency resulting in bloating or excessive gas after taking milk products.
A)true
B)false
A
Do you use antacids? How often?
A)Pyrosis (heartburn), a burning sensation in esophagus and stomach, from reflux of gastric acid.
B)false
A
__________(heartburn), a burning sensation in esophagus and stomach, from reflux of gastric acid.
Pyrosis
burning sensation in esophagus and stomach, from reflux of gastric acid.
Pyrosis
Abdominal Pain
,
Abdominal pain. Any abdominal pain? Please point to it. • Is the pain in one spot, or does it move around? How did it start? How long have you had it? Constant, or does it come and go? Occur before or after meals? Does it peak? When?
A)Abdominal pain may be visceral from an internal organ (dull, general, poorly localized); parietal from inflammation of overlying peritoneum (sharp, precisely localized, aggravated by movement); or referred from a disorder in another site
B)none
A
Abdominal pain may be visceral from an internal organ (dull, general, poorly localized);
A) true
B)false
A
parietal from inflammation of overlying peritoneum (sharp, precisely localized, aggravated by movement);
A) true abdominal pain
B) false
A
How would you describe the character: cramping (colic type), burning in pit of stomach, dull, stabbing, aching?
A)Acute pain requiring urgent diagnosis occurs with appendicitis, cholecystitis, bowel obstruction, or a perforated organ.
B)false
A
Is the pain relieved by food, or worse after eating?
A)Chronic pain of gastric ulcers occurs usually on an empty stomach; pain of duodenal ulcers occurs 2 to 3 hours after a meal and is relieved by more food.
B)false
A
Chronic pain of gastric ulcers occurs usually on an empty stomach;
A)true
B) false
A
pain of duodenal ulcers occurs 2 to 3 hours after a meal and is relieved by more food.
A)true
B)false
A
Is the pain associated with menstrual period or irregularities, stress, dietary indiscretion, fatigue, nausea and vomiling, gas, fever, rectal bleeding, frequent urination, vaginal or penile discharge?
A)assessing for abdominal pain
B)false
A
What makes the pain worse: food, position, stress, medication, activity? What have you tried to relieve pain: rest, heating pad, change in position, medication?
A)assessing for abdominal pain
B)false
A
Nausea/Vomitting
,
Nausea/vomiting. • Any nausea or vomiting? How often? How much comes up? What is the color? Is there an odor?
A)Nausea/vomiting is common with GI disease, many medications, and with early pregnancy.
B)false
A
Nausea/vomiting is common with GI disease, many medications, and with early pregnancy.
A)true
B)false
A
Is it bloody?
A)Hematemesis occurs with stomach or duodenal ulcers and esophageal varices.
B)false
A
Hematemesis occurs with stomach or duodenal ulcers and esophageal varices.
A)true
B)false
A
Is the nausea and vomiting associated with colicky pain, diarrhea, fever, chills?
A)assessing for nausea and vomiting
B) false
A
What foods did you eat in the past 24 hours? Where? At home, school, restaurant? Is there anyone else in the family with same symptoms in past 24 hours?
A)Consider food poisoning.
B)false
A
Bowel Habits
M
Bowel habits. How often do you have a bowel movement?
A)Assess usual bowel habits
B)false
A
What is the color? Consistency? Any diarrhea or constipation? How long? • Any recent change in bowel habits? Use laxatives? Which ones? How often do you use them?
A)Black stools may be tarry due to occult blood (melena) from GI bleeding or nontarry from iron medications. Gray stools occur with hepatitis.
B)false
A
Black stools may be tarry due to occult blood (melena) from GI bleeding or nontarry from iron medications.
A)true
B)false
A
Gray stools occur with hepatitis.
A)true
B)false
A
Red blood in stools occurs with GI bleeding or localized bleeding around the anus.
A)true
B)false
A
Past Abdominal History
,
Past abdominal history. Any history of gastrointestinal problems: ulcer, gallbladder disease, hepatitis/jaundice, appendicitis, colitis, hernia? • Ever had any operations in the abdomen? Please describe. Any problems after surgery? • Any abdominal x-ray studies? How were the results?
A)assessing for abdominal history
B)false
A
Medications
,
Medications. What medications are you currently taking?
A)Peptic ulcer disease occurs with frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, smoking, and Helicobacter pylori infection
B)false
A
Peptic ulcer disease occurs with frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, smoking, and Helicobacter pylori infection.
A)true
B)false
A
How about alcohol-how much would you say you drink each day? Each week? When was your last alcoholic drink? • How about cigarettes-do you smoke? How many packs per day? For how long?
A) assessing
B)false
A
Nutritional Assessment
,
Nutritional assessment. Now I would like to ask you about your diet. Please tell me all the food you ate yesterday, starting with breakfast.
A)Nutritional assessment via 24-hour recall
B)false
A
What fresh food markets are located in your neighborhood?
A)Many inner-city neighborhoods are fresh food “deserts” lacking markets but full of fast-food restaurants.
B)false
A
Additional History for Infants and Children
,
Are you breastfeeding or bottle-feeding the baby? If bottle-feeding, how does baby tolerate the formula?
A)assessing
B)false
A
What table foods have you introduced? How does the infant tolerate the food?
A)Consider a new food as a possible allergen. Adding only one new food at a time to the infant’s diet helps identify allergies
B)false
A
How often does your toddler/child eat? Does he or she eat regular meals? How do you feel about your child’s eating problems? • Please describe all that your child had to eat yesterday, starting with breakfast. What foods does the child eat for snacks?
A)Irregular eating patterns are common and a source of parental anxiety. As long as the child shows normal growth and development and only nutritious foods are offered, parents may be reassured.
B)false
A
Irregular eating patterns are common and a source of parental anxiety.
A)infants
B)adults
A
Does toddler/child ever eat nonfoods: grass, dirt, paint chips?
A)assessing for pica
B)Pica: Although a toddler may attempt nonfoods at some time, he or she should recognize edibles by age 2 years.
C)both a and b
C
Pica: Although a toddler may attempt nonfoods at some time, he or she should recognize edibles by age 2 years.
A)true
B)false
A
Does your child have constipation? How long? • What is the number of stools/day? Stools/week? • How much water, juice is in the diet? • Does the constipation seem to be associated with toilet training? • What have you tried to treat the constipation?
A)assessing for constipation
B)false
A
Does the child have abdominal pain? Please describe what you have noticed and when it started.
A)This symptom is hard to assess with young children. Many conditions of unrelated organ systems are associated with vague abdominal pain (e.g., otitis media). They cannot articulate specific symptoms and often focus on “the tummy.”
B)Abdominal pain accompanies inflammation of the bowel, constipation, urinary tract infection, and anxiety.
C) both a and b
C
Abdominal pain accompanies inflammation of the bowel, constipation, urinary tract infection, and anxiety.
A)true
B)false
A
For the overweight child: How long has weight been a problem? At what age did the child first seem overweight? Did any change in diet pattern occur then? • Describe the diet pattern now.
A)Reduced physical activity and food marketing practices contribute to current obesity epidemic.
B)false
A
Do any others in family have a similar problem?
A)assessing for Family history of obesity.
B)false
A
How does child feel about his or her own weight?
A)Assess body image
B)false
A
Additional History for Adolescents
,
What do you eat at regular meals? Do you eat breakfast? What do you eat for snacks?
A)Adolescent takes control of eating and may reject family values (e.g., skipping breakfast, consuming junk foods, soda pop). The only control parents have is to control what food is in the house.
B)false
A
How many calories do you figure you consume?
A)You probably cannot change adolescent eating pattern, but you can supply nutritional facts.
B)false
A
What is your exercise pattern?
A)Boys need an average 4000 cal/day to maintain weight; more calories if exercise is pursued. Girls need 20% fewer calories and the same nutrients as boys. Fast food is high in fat, calories, and salt and has no fiber.
B)false
A
Boys need an average 4000 cal/day to maintain weight; more calories if exercise is pursued.
A)true
B)false
A
Girls need 20% (3200) fewer calories and the same nutrients as boys.
A)true
B)false
A
Fast food is high in fat, calories, and salt and has no fiber.
A)true
B)false
A
If weight is less than body requirements: How much have you lost? By diet, exercise, or how?
A)Screen any extremely thin teenage girl for anorexia nervosa, a serious psychosocial disorder that includes loss of appetite, voluntary starvation, and grave weight loss. This person may augment weight loss by purging (self-induced vomiting) and use of laxatives.
B)false
A
Screen any extremely thin teenage girl for _____________, a serious psychosocial disorder that includes loss of appetite, voluntary starvation, and grave weight loss. This person may augment weight loss by purging (self-induced vomiting) and use of laxatives
anorexia nervosa
How do you feel? Tired, hungry? How do you think your body looks?
A)Denial of these feelings is common. Though thin, this person insists she looks fat, “disgusting.” Distorted body image.
B)false
A
What is your activity pattern?
A)The anorectic may have healthy activity and exercise but often is hyperactive.
B) false
A
Is the weight loss associated with any other body change, such as menstrual irregularity?
A)Amenorrhea is common with anorexia nervosa
B)false
A
Amenorrhea is common with anorexia nervosa
A)true
B)false
A
What do your parents say about your eating? Your friends?
A)This is a family problem involving control issues. Anyone at risk warrants immediate referral to a physician or psychologist.
B)false
A
Additional History for the Aging Adult
,
How do you acquire your groceries and prepare your meals?
A)Assess risk for nutritional deficit: limited access to grocery store, income, or cooking facilities; physical disability (impaired vision, decreased mobility, decreased strength, neurologic deficit)
B)false
A
Do you eat alone or share meals with others?
A)Assess risk for nutritional deficit if living alone; may not bother to prepare all meals; social isolation; depression
B)false
A
Please tell me all that you had to eat yesterday, starting with breakfast.
A) NOTE: 24-hour recall may not be sufficient because daily pattern may vary. Attempt week-long diary of intake. Food -pattern may differ during the month if monthly income (e.g., Social Security check) runs out.
B)false
A
Do you have any trouble swallowing these foods? What do you do right after eating: walk, take a nap?
A)assessing
B)false
A
How often do your bowels move? If the person reports constipation: What do you mean by constipation? How much liquid is in your diet? How much bulk or fiber? • Do you take anything for constipation, such as laxatives? Which ones? How often?
A)assessing
B)false
A
What medications do you take?
A)Consider GI side effects (e.g., nausea, upset stomach, anorexia, dry mouth).
B)false
A
OBJECTIVE DATA
,
PREPARATION
,
Expose the abdomen so that it is fully visible. Drape the genitalia and female breasts.
A)true
B) false
A
The following measures will enhance abdominal wall relaxation:
,
- The person should have emptied the bladder, saving a urine specimen if needed.
- Keep the room warm to avoid chilling and tensing of muscles.
• Position the person supine, with the head on a pillow, the knees bent or on pillow, and the arms at the sides or across the chest. (Note: Discourage the person from placing his or her arms over the head because this tenses abdominal musculature.)
- To avoid abdominal tensing, the stethoscope endpiece must be warm, your hands must be warm, and your fingernails must be very short.
- Inquire about any painful areas. Examine such an area last to avoid any muscle guarding.
- Finally, learn to use distraction: Enhance muscle relaxation through breathing exercises; emotive imagery; your low, soothing voice; engaging in conversation or the person relating his or her abdominal history while you palpate.
The following measures will enhance abdominal wall relaxation:
EQUIPMENT NEEDED
,
Stethoscope
Small centimeter ruler
Skin-marking pen
Alcohol wipe (to clean endpiece)
,
INSPECT THE ABDOMEN
,
Contour of the abdomen. Stand on the person’s right side and look down on the abdomen. Then stoop or sit to gaze across the abdomen. Your head should be slightly higher than the abdomen. Determine the profile from the rib margin to the pubic bone. The contour describes the nutritional state and normally ranges from flat to rounded.
A) true
B)false
A
To check the contour of the abdomen. Determine the profile from the rib margin to the pubic bone. The contour describes the nutritional state and normally ranges from flat to rounded.
A) true
B)false
A
Scaphoid abdomen caves in. Protuberant abdomen and abdominal distention
A)abnormal findings of the contour of the abdomen
B)false
A
Symmetry
,
Shine a light across the abdomen toward you, or shine it lengthwise across the person. The abdomen should be symmetric bilaterally. Note any localized bulging, visible mass, or asymmetric shape. Even small bulges are highlighted by shadow. Step to the foot of the examination table to recheck symmetry.
A)true
B)false
A
Bulges, masses in the abdomen are abnormal findings
A)true
B)false
A
Hernia-protrusion of abdominal viscera through abnormal opening in muscle wall.
A)abnormal finding
B)normal finding
A
________-protrusion of abdominal viscera through abnormal opening in muscle wall
Hernia
Ask the person to take a deep breath to further highlight any change. The abdomen should stay smooth and symmetric. Or ask the person to perform a sit-up without pushing up with his or her hands.
A)Note any localized bulging.
B)Hernia, enlarged liver or spleen may show.
C)both a and b
C
Ask the person to take a deep breath to further highlight any change. The abdomen should stay smooth and symmetric. Or ask the person to perform a sit-up without pushing up with his or her hands. Note any localized bulging. An abnormal finding would be a Hernia, or enlarged liver or spleen may show.
A)true
B)false
A
Another symptom is “acid indigestion” or heartburn (pyrosis) caused by esophageal reflux. Gastrointestinal motility decreases, which prolongs gastric emptying time. The decreased motility causes more water to be reabsorbed from the colon, which leads to constipation. The constipation, as well as increased venous pressure in the lower pelvis, may lead to hemorrhoids.
A)true, pregnant women
B)false
A
Umbilicus
,
Normally it is midline and inverted, with no sign of discoloration, inflammation, or hernia. It becomes everted and pushed upward with pregnancy.
A)umbilicus
B)false
A
It becomes everted and pushed upward with pregnancy.
Umbilicus
The umbilicus that is Everted in a normal person occurs with ascites or underlying mass
A)true
B)false
A
The umbilicus is a common site for piercings in young women. The site should not be red or crusted.
A)true
B)false
A
An abnormal finding in the umbilicus would be Deeply sunken with obesity. Enlarged, everted with umbilical hernia.
A)true
B)false
A
Umbilicus that is deeply sunken mostly like means the person obese.
A)true
B)false
A
Umbilicus that is enlarge and everted most likely mean the person has a hernia.
A)true
B)false
A
Bluish periumbilical color occurs (though rarely) with intra-abdominal bleeding (Cullen sign).
A)true
B)false
A
Cullen sign shows Bluish periumbilical color occurs (though rarely) with intra-abdominal bleeding.
A)true
B)false
A
Skin
,
The surface is smooth and even, with homogeneous color. This is a good area to judge pigment because it is often protected from sun.
A)skin
B)umbilicus
A
The skin appears as Redness with localized inflammation.
A)true
B)false
A
Jaundice (yellowing of skin and sclera) shows best in natural daylight.
A)abnormal finding of the skin
B)abnormal finding of the umbilicus
A
Skin that appears glistening and taut occurs with ascites.
A)true
B)false
A
One common pigment change is striae (lineae albicantes)-silvery white, linear, jagged marks about 1 to 6 cm long. They occur when elastic fibers in the reticular layer of the skin are broken after rapid or prolonged stretching, as in pregnancy or excessive weight gain. Recent striae are pink or blue; then they turn silvery white.
A)true
B)false
A
They occur when elastic fibers in the reticular layer of the skin are broken after rapid or prolonged stretching, as in pregnancy or excessive weight gain. Recent striae are pink or blue; then they turn silvery white.
One common pigment change is striae (lineae albicantes)-silvery white, linear, jagged marks about 1 to 6 cm long.
Abnormal finding of Striae also occur with ascites.
A)true
B)false
A
Striae look purple-blue with Cushing syndrome (excess adrenocortical hormone causes the skin to be fragile and easily broken from normal stretching).
A)abnormal finding of the skin
B)false
A
________ look purple-blue with Cushing syndrome (excess adrenocortical hormone causes the skin to be fragile and easily broken from normal stretching).
Striae
Cushing syndrome (excess adrenocortical hormone causes the skin to be fragile and easily broken from normal stretching). A)true B) false
A
Pigmented nevi (moles)- circumscribed brown macular or papular areas, are common on the abdomen. A)true,skin B)false, skin
A
Abnormal finding would be that Unusual color or change in shape of mole occurs on the skin
A)true
B)false
A
Petechiae is a small red or purple spot caused by bleeding into skin.
A)true, abnormal
B)false, normal
Aa
Normally, no lesions are present, although you may note well-healed surgical scars. If a scar is present, draw its location in the person’s record, indicating the length in centimeters .
A)true for skin
B)false for skin
A
Note: Infrequently, a person may forget a past operation while providing the history. If you note a scar now, ask about it.)
A)true
B)false
A
A surgical scar alerts you to the possible presence of underlying adhesions and excess fibrous tissue.
A)true
B)false
A
Cutaneous angiomas (spider nevi) on the skin occur with portal hypertension or liver disease. A)true B)false
A
_________ (spider nevi) on the skin occur with portal hypertension or liver disease.
Cutaneous angiomas
Underlying adhesions are inflammatory bands that connect opposite sides of serous surfaces after trauma or surgery.
A)true,skin
B)false,skin
A
Underlying adhesions are inflammatory band that occur after trauma or surgery.
A)true
B)false
A
