Abdomen Flashcards
Where is the dome of the diaphragm? (rib wise)
5th anterior intercostal space
What are sx of acute cholecystitis?
RUQ pain, fever, nausea, vomiting, tenderness, palpable gallbladder
What is a visceral pattern of abdominal pain?
gnawing, burning, cramping aching
distension of organ against capsule
What is a parietal pattern of pain?
steady, aching, worse w/ movement
from inflammation of parietal peritoneum, often still, hurts to move
What is a referred pattern of pain?
Seems to radiate
felt at same spinal level, duodenal/pancreatic radiates to the back
What are sx of dyspepsia?
- chronic/recurrent central upper abdominal pain
- postprandial fullness, early satiety, epigastric burning
- bloating, nausea, heartburn
What are sx of GERD?
heartburn + regurgitation > 1 week
- atypical respiratory sx
- pharyngeal sx
What are alarm sx that you need to be concerned about?
- dysphagia
- odynophagia
- recurrent vomiting
- melena or bright red blood per rectum
- early satiety
- weight loss
- anemia
- palpable mass
- painless jaundice
What will you likely hear in a small/large bowel obstruction?
distension and hyperactive bowel sounds
What is a sign of mesenteric ischemia?
loss of lack of appetite, “food fear”
What can cause diarrhea?
- medications
- inflammatory bowel conditions
- recent hospitalization (C. Diff)
What can cause constipation?
- medications
- Pencil-like stools (sigmoid colon obstruction)
What is melena?
- black/tarry stools
could be due to upper GI bleed, ucler, varices, Mallory-Weiss tear, reflux esophigitis - will have positive hemoccult
What is hematochezia?
- bright red blood
due to: colon cancer, polyps, inflammatory conditions, hemorrhoids, anal fissure
What is the order you need to follow when performing the abdominal PE?
- inspect
- auscultate
- palpate
- percuss
What does increased, high ptiched, tinkling bowel sounds mean?
early obstruction, diarrhea
What kind of bowel sounds will you hear in the ileus?
Hypoactive
What type of bowel sounds will you hear in peritonitis?
Absent soudns
What does tympany in the abdomen suggest?
gas
What does dullness in the bowel suggest?
fluid/feces/solid organ/mass
What do you suspect if a pt has CVA tenderness?
- Kidney problem
- pyelonephritis, nephorlithiasis, hydronepherosis
Where do you expect to hear dullness and tympany in ascites?
dullness on the flank, tympany is central
How do you test shifting dullness?
have the pt roll on one side and the tympany should shift to the top
What is the problem with the fluid wave test?
It is not specific and can be positive without ascites and negative with ascites
