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Physical Assessment > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What are the organs involved in the digestive system?

A
  1. mouth
  2. esophagus
  3. stomach
  4. small intestines
  5. large intestines
  6. liver
  7. pancreas
  8. gall bladder
  9. pancreas
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2
Q

List other organ that are in the abdomen

A 
1. aorta 
2, kidneys 
3. ureters 
4. bladder 
5. spleen
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3
Q

List the number and region of the quadrants used by nurses

A
  1. RLQ
  2. RUQ
  3. LUQ
  4. LLQ
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4
Q

List the 9 quadrants that can be used as landmarks

A
  1. R hypochondriac
  2. Epigastric
  3. L Hypochondriac
  4. R Lumbar
  5. Umbilical
  6. L lumbar
  7. R Inguinal
    8, Hypogastric
  8. L inguinal
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5
Q

Which structures are in the midline

A
  1. aorta
  2. urinary bladder
  3. uterus
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6
Q

Describe the abdomen of a newborn and infant? Toddler?

A

round for infants and newborn; “potbelly” for toddlers

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7
Q

If you see a toddler who’s respirations are abdominal, is this a major concern?

A

no, movement of the abdomen is seen w/ breathing

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8
Q

In children, how do you know the child has hepatomegaly?

A

any liver edge is palpable more than 2 cm below the costal margin

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9
Q

What is Wilms’ tumor?

A

a malignancy of the kidney

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10
Q

What are the result of a protrusion at the umbilicus cord visible at birth? Is this a medical emergency?

A

umbilical hernia; no it is not a medical ER unless that incarcerate

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11
Q

What is an acute diarrhea disease that may or may not be accompanied with vomiting in children?

A

acute gastroenteritis

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12
Q

What changes in the abdomen during pregnancy?

A
  1. the uterus enlarged and moves into the abdominal cavity
  2. by the 36th week the fundus is high in the abdomen
  3. stretch marks
  4. linea nigra
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13
Q

Shelly is pregnant, what can you expect to see as a result of displacement of organs in the abdomen?

A
  1. constipation
  2. flatulence
  3. hemorrhoids
  4. frequent voiding
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14
Q

What are some common GI disturbances in pregnant women?

A
  1. heartburn
  2. N/V
  3. Constipation
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15
Q

What is the the most common problem in older adults?

A

constipation

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16
Q

What are some factors that contribute to constipation is older adults? Which is contributing?

A
  1. decreased GI motility
  2. impaired physical mobility
  3. meds (NSAIDS, opioids, anticholinergics)
  4. loss of teeth
  5. lack of fluids- most contributing
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17
Q

How does an older adults abdomen differ from a young adult?

A

an older person has a softer and more relaxed abdomen

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18
Q

Ascites

A

a distended abdomen often seen w/ fluid in the peritoneal cavity or excessive gas

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19
Q

Borborygmi

A

stomach growling

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20
Q

What does tarry stool indicate?

A

bleeding in the upper part of the GI tract or iron supplements

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21
Q

What does brown vomitus w/ fecal odor indicate?

A

intestinal obstruction

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22
Q

Sharon is c/o pain, N/V, what may this indicate?

A

underlying abdominal disease

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23
Q

What does bright red stool indicate?

A

lower tract bleeding

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24
Q

What is your process for assessing the abdomen?

A
  1. inspect
  2. auscultate
  3. percussion
  4. palpation
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25
Q

What is the position the pt should be in to begin the assessment?

A

supine w/ a small pillow place behind head and knees

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26
Q

A protuberant abdomen is normal for toddlers and pregnant women, but what it indicate in a nonpregnant pt?

A

obesity or ascites

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27
Q

Which type pf pt would you expect to see a flat abdomen during inspection?

A

thin person

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28
Q

Which type of pt would you expect to see a rounded abdomen during inspection?

A

toddler and pregnant women

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29
Q

Where is the location of the horizontal line in a pt w/ scaphoid abdomen?

A

inward toward the vertebral column

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30
Q

Where is the location of the horizontal line in a pt w/ a rounded abdomen?

A

outward

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31
Q

What type of pt would you expect to see a scaphoid abdomen?

A

very thin pt

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32
Q

Describe the skin for a pt w/ ascites/

A

taut and glistening

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33
Q

When observing for symmetry on the abdomen, you notice the abdomen is asymmetrical, what may this indicate?

A

masses, adhesions, or strictures of underlying structures

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34
Q

When observing the abdomen, you noticed shadows what may this indicate?

A

bulges or masses

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35
Q

What does a bulge indicate?

A

tumors, cysts, or hernias

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36
Q

What does increased peristaltic activity indicate?

A

gastroenteritis or an obstructive process

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37
Q

During auscultation, what can you expect to hear in a normal pt?

A

irregular, high-pitches gurgling sounds

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38
Q

What do you hear when auscultating hyperactive bowel sounds?

A

loud, high-pitched and rushing

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39
Q

What do you hear when auscultating hypoactive bowel sounds?

A

slow and sluggish

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40
Q

Which pts produce hypoactive bowel sounds?

A

post-op or bowel obstruction or constipated

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41
Q

Which pts produce hyperactive bowel sounds?

A

diarrhea or gastroenteritis

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42
Q

What type of pts may have absence of bowel sounds?

A

paralytic ileus

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43
Q

During percussion, what is the normal sound?

A

tympany

44
Q

Describe tympany

A

loud hollow sound

45
Q

When percussing the intestines you hear hyperresonance, what may this indicate?

A

air-filled or distended

46
Q

What are the causes of abdominal distention?

A
  1. obesity
  2. gaseous distention
  3. ascites
  4. abdominal tumor
47
Q

Describe an abdominal tumor

A

abdomen is firm and dull to percuss

48
Q

What type of distention is common in ovarian and uterine tumors?

A

abdominal tumors

49
Q

What causes gaseous distention?

A

an increased production of gas on the intestines which occurs w. the ingestion os some foods

50
Q

What do you hear when you percuss gaseous distention?

A

tympany over a lg area

51
Q

What do you hear when you percuss ascites?

A

dullness in the lower abdomen

52
Q

How do you assess a pt with ascites?

A

place the pt in a lateral position and observing fluid shift to the dependent side

53
Q

What type of pts may develop ascites?

A
  1. cirrhosis
  2. CHF
  3. nephrosis
  4. peritonitis
  5. neoplastic diseases
54
Q

What are the hernias listed in the book?

A
  1. umbilical
  2. ventral (incisional)
  3. Hiatal hernia
55
Q

Describe an umbilical hernia

A

occurs when the abdominal rectus muscles separates or weakens allowing abdominal structures (usually intestine) to push through and come closer to the skin

56
Q

Describe a hiatal hernia

A

weakening in the diaphragm allowing a portion of the stomach and esophagus to move into the thoracic cavity

57
Q

Describe a ventral (incisional) hernia

A

occurs at the site of an incision when the incision weakens the muscle and the abdominal structures move closer to the skin

58
Q

List the causes of ventral hernias

A
  1. obesity
  2. repeated surgeries
  3. postop infxn
  4. impaired wound
  5. wound healing
  6. poor nutrition
59
Q

List some risk factors for pancreatic cancer

A
  1. smoking
  2. race
  3. age
  4. genetic disposition
60
Q

What may you see in someone with pancreatic cancer?

A
  1. extreme weight loss
  2. jaundice
  3. dark-colored urine
  4. diarrhea
  5. greasy, pale-colored stool
61
Q

What you may see in someone with stomach cancer?

A
  1. weight loss
  2. vomiting
  3. GI bleeding
  4. cancerous lesions primarily located in the distal third of the stomach
62
Q

What may you see in someone with hepatic cancer?

A
  1. ascites
  2. jaundice
  3. vomiting
  4. pale or white stool
63
Q

Is Jon has pancreatic cancer what may he c/o of?

A
  1. upper and middle to L quadrant abdominal pain that radiates to the back
  2. Nausea
  3. pruritis
64
Q

If Lee has stomach cancer what may he c/o of?

A
  1. indigestion
  2. loss of appetite
  3. sense of abdominal bloating after eating
  4. nausea
  5. abdominal pain
65
Q

What person with hepatic cancer c/o of?

A
  1. RUQ pain
  2. bruising or bleeding easily
  3. nausea
  4. fatigue
66
Q

What are SI/Sx of colorectal cancer?

A
  1. rectal bleeding
  2. unexplained weight loss
  3. intestinal obstruction
67
Q

What are some objective findings of colorectal cancer?

A
  1. variation in bowel habits or elimination patterns
  2. abdominal cramping or pain
  3. fatigue
  4. increased production of intestinal gas
68
Q

What are some common GI inflammatory processes?

A
  1. Crohn’s
  2. UC
  3. Peritonitis
  4. Esophagitis
  5. Hepatitis
69
Q

What are some causes of esophagitis?

A
  1. ETHOL abuse
  2. smoking
  3. acid reflux
  4. indigestion of hit and cold
70
Q

What are Si/Sx of esophagitis?

A
  1. vomiting
  2. weight loss
  3. esophageal obstruction
71
Q

What are some objective findings of esophagitis?

A
  1. dysphagia
  2. chest pain
  3. nausea
72
Q

What does dullness indicate in the abdomen?

A
  1. enlarged uterus
  2. ascites
  3. distended urinary bladder
73
Q

What does dullness in the LLQ indicate?

A

presence of stool so ask when the pt had their last bm

74
Q

When you percuss the liver what sound do you normally hear?

A

dull to percuss

75
Q

While percussing the liver you hear dullness above the 5th or 6th ICS, what does this indicate? Explain

A

enlarged liver because the liver typically has an upper border in the 5th or 6th ICS.

76
Q

What is the liver span?

A

measures distance between upper and lower border of the liver which is approx, 5-10 cm or 2-4in

77
Q

How do you determine the movement of the liver?

A

ask the pt to take a breath and hold it

78
Q

When you percuss the spleen, how do you know the pt has splenomegaly?

A

dullness is heard at the L anterior axillary line

79
Q

What is referred pain?

A

abdominal pain from an organ that is felt on the surface of the abdomen or back

80
Q

Which pts do you not palpate?

A
  1. suspected appendicitis
  2. abdominal aortic aneurysm
  3. Polycystic kidneys
  4. transplanted organs
81
Q

Which part of the hand do your palpate the abdomen w/?

A

palmar surface

82
Q

Can you palpate the spleen?

A

no

83
Q

Describe Blumberg’s sign

A

when palpating for tenderness the pt should feel no pain, however when the pt experiences a sharp stabbing pain as the compressed area returns to the non-compressed state

84
Q

What is McBurney’s Pt?

A

pain referred to 2.5-5.1 cm or 1 to 2 in above the anterosuperior iliac spine on a line between the ileum and the umbilicus

85
Q

What is Rovsing’s sign?

A

pain during palpation of the L lower abdomen

86
Q

What does McBurney’s pt and Rovsing’s sign apply to?

A

appendicitis

87
Q

What is the name of alt method to percuss for ascites?

A

shifting dullness

88
Q

Describe how to shift dullness for ascites?

A

position the pt on R or L side and percuss

89
Q

What is the purpose of Psoas sign?

A

when lower abdominal pain is present and you suspect appendicitis this exacerbates the pain

90
Q

Describe how to do the Psoas sign?

A

Place the pt in a supine position, place your L hand above the level of the pt’s R knee. Ask the pt to raise their leg to meet your hand.

91
Q

How does the Psoas work?

A

flexion of the hip causes contraction of the psoas muscle

92
Q

How to do the Murphy’s sign?

A

while palpating the liver ask the pt to take a deep breath? the diaphragm descends pushing the liver and gallbladder toward your hand

93
Q

In a healthy pt does palpating the liver hurt?

A

no

94
Q

If the pt is positive for Murphy’s sign what does this mean?

A

cholecysitis

95
Q

Where and in what cases do you hear friction rub?`

A

LUQ and RUQ over the liver and spleen due to tumor or inflammation of the organ

96
Q

List the inflammatory process discussed in the book

A
  1. UC
  2. Crohn’s
  3. esophagitits
  4. peritonitis
  5. Hepatitis
97
Q

List the types of hepatitis

A
  1. Hep A
  2. Hep B
  3. Hep C
  4. Hep D
  5. Hep E
98
Q

How is hepatitis A transmitted?

A

fecal-oral

99
Q

How is Hep B transmitted?

A

parenteral, sexually or periontonally

100
Q

How is Hep C transmitted?

A

blood products

101
Q

How is Hep D transmitted?

A

same as Hep B

102
Q

How is Hep E transmitted?

A

enteral

103
Q

List the types of hernias

A
  1. umbilical
  2. ventral
  3. Hiatal
104
Q

Describe a hiatal hernia

A

this occurs when the stomach and esophagus move into the thoracic cavity; can be rolling or sliding (adults> children)

105
Q

How does someone get a ventral hernia?

A
  1. repeated surgeries
  2. obesity
  3. impaired wound healing
  4. poor nutrition
106
Q

Describe an umbilical hernia

A

the rectus abdominus muscle weakens causing the protrusion of the intestines to become closer to the surface of the skin (children > adults

Physical Assessment (10 decks)

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