Abdomen Flashcards

1
Q

Abdomen assessment

A
stand on the patients right side
order of assessment: 
Inspection
auscultation
percussion
palpation
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2
Q

inspection

A
Scars
Striae
Dilated veins
Rashes/lesions
Masses
Umbilicus
Contour
Symmetry
Peristalsis
Pulsations
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3
Q

Scars/Striae note

A

size, color, location

striae may be silvery color, stretch marks due to pregnancy, rapid weight gain or large weight loss

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4
Q

dilated veins

A

prominent, dilated veins occur with portal hypertension, cirrhosis, ascites, vena cava obstruction, and malnutrition

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5
Q

Rashes, lesions, masses

A

link to skin assessment
ABCDE
asymmetry, border, color, diameter, elevation and enlargement

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6
Q

umbilicus

A

note contour, location, and any signs of inflammation or hernia. An umbilical hernia protrudes through the umbilicus

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7
Q

Contour of abdomen

A

flat: appropriate weight and muscle tone
scaphoid: sunken (dehydration)
rounded: slightly obese, early pregnancy
protuberant: pregnancy, distension, obesity, tumors, ascites

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8
Q

Peristalsis

A

eye level to assess
may need to observe for several mintues
may be visible in thin individuals

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9
Q

Pulsations

A

aortic pulsation may be visible in the epigastric area

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10
Q

Auscultation

A

Warm the diaphragm

Begin in RLQ, then to RUQ, LUQ, LLQ

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11
Q

Bowel Sounds

A
Normal: 5-30 per minute
Hypoactive: less than 5/minute
Hyperactive: more than 30/minutes
borborygmus: stomach growling 
Absent sounds: must listen for 5 minutes; result of decreased intestinal motility, paralytic ileus, late bowel obstruction, peritonitis, appendicitis
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12
Q

Venous Hum

A

continuous medium pitched sound auscultated in the epigastric and umbilical area. may indicate hepatic cirrohosis

very rare
listen with bell

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13
Q

Friction rub

A

rough grating sound
may indicated infection, inflammation, and malignancy

listen with diaphragm

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14
Q

percuss

A

purpose is to detect fluid, gaseous distension, and masses

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15
Q

tympany

A

Lightly percuss in all four quadrants
Move clockwise
Air in the intestines rises to the surface when supine

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16
Q

Dullness

A

Distended bladder
Adipose tissue
Fluid
Mass

17
Q

Hyperresonance

A

Gaseous distention

18
Q

liver span

A

percuss down along the right midclavicular line beginning at the nipple area, moving from lung resonance to liver dullness. mark with china pin

19
Q

liver span cont

A

percuss up along the right midclavicular line from the level of the umbilicus to liver dullness. mark with pin

measure with tape should be 6-12 inches in the adult. The liver width is greater in men and tall individuals

20
Q

percuss spleen

A

9th or 10th mid axillary line and percuss, shoudl be tympanic

dull sound could be mono, trauma, or infection

21
Q

percuss stomach

A

gastric air bubble, left side of patient 6th or 7th rib

should be tympanic

22
Q

palpation

A

begin with light palpation
start in RLQ, RUQ, LUQ, LLQ
muscular resistance- muscle tone
abdominal tenderness- stiffening with pain

23
Q

deep palpation

A

used to distinguish inferior organs or elicit deep pain

24
Q

deep masses

A

note size, location, mobility, contour, consistency(soft, firm or hard), tenderness

25
tender areas
palpate last
26
aorta
press deep into the upper abdomen slightly to the left of the midline. identify the aortic pulsation Normally 2.5 cm – 4 cm in the adult abnormal finding: widened w/ aneurysm
27
upper abdominal reflexes
stroke the abdomen toward the umbilicus with the handle of the reflex hammer should move toward the stimulus
28
lower abdominal
stroke the abdomen below the umbilical area but towards the midline umbilicus should deviate towards the stimulus
29
Absent reflex
could indicate a pyramidal tract lesion