Abdomen Flashcards
1
Q
What are the organs involved in the digestive system?
A
- mouth
- esophagus
- stomach
- small intestines
- large intestines
- liver
- pancreas
- gall bladder
- pancreas
2
Q
List other organ that are in the abdomen
A
1. aorta 2, kidneys 3. ureters 4. bladder 5. spleen
3
Q
List the number and region of the quadrants used by nurses
A
- RLQ
- RUQ
- LUQ
- LLQ
4
Q
List the 9 quadrants that can be used as landmarks
A
- R hypochondriac
- Epigastric
- L Hypochondriac
- R Lumbar
- Umbilical
- L lumbar
- R Inguinal
8, Hypogastric - L inguinal
5
Q
Which structures are in the midline
A
- aorta
- urinary bladder
- uterus
6
Q
Describe the abdomen of a newborn and infant? Toddler?
A
round for infants and newborn; “potbelly” for toddlers
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
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
9
Q
What is Wilms’ tumor?
A
a malignancy of the kidney
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
11
Q
What is an acute diarrhea disease that may or may not be accompanied with vomiting in children?
A
acute gastroenteritis
12
Q
What changes in the abdomen during pregnancy?
A
- the uterus enlarged and moves into the abdominal cavity
- by the 36th week the fundus is high in the abdomen
- stretch marks
- linea nigra
13
Q
Shelly is pregnant, what can you expect to see as a result of displacement of organs in the abdomen?
A
- constipation
- flatulence
- hemorrhoids
- frequent voiding
14
Q
What are some common GI disturbances in pregnant women?
A
- heartburn
- N/V
- Constipation
15
Q
What is the the most common problem in older adults?
A
constipation
16
Q
What are some factors that contribute to constipation is older adults? Which is contributing?
A
- decreased GI motility
- impaired physical mobility
- meds (NSAIDS, opioids, anticholinergics)
- loss of teeth
- lack of fluids- most contributing
17
Q
How does an older adults abdomen differ from a young adult?
A
an older person has a softer and more relaxed abdomen
18
Q
Ascites
A
a distended abdomen often seen w/ fluid in the peritoneal cavity or excessive gas
19
Q
Borborygmi
A
stomach growling
20
Q
What does tarry stool indicate?
A
bleeding in the upper part of the GI tract or iron supplements
21
Q
What does brown vomitus w/ fecal odor indicate?
A
intestinal obstruction
22
Q
Sharon is c/o pain, N/V, what may this indicate?
A
underlying abdominal disease
23
Q
What does bright red stool indicate?
A
lower tract bleeding
24
Q
What is your process for assessing the abdomen?
A
- inspect
- auscultate
- percussion
- palpation
25
What is the position the pt should be in to begin the assessment?
supine w/ a small pillow place behind head and knees
26
A protuberant abdomen is normal for toddlers and pregnant women, but what it indicate in a nonpregnant pt?
obesity or ascites
27
Which type pf pt would you expect to see a flat abdomen during inspection?
thin person
28
Which type of pt would you expect to see a rounded abdomen during inspection?
toddler and pregnant women
29
Where is the location of the horizontal line in a pt w/ scaphoid abdomen?
inward toward the vertebral column
30
Where is the location of the horizontal line in a pt w/ a rounded abdomen?
outward
31
What type of pt would you expect to see a scaphoid abdomen?
very thin pt
32
Describe the skin for a pt w/ ascites/
taut and glistening
33
When observing for symmetry on the abdomen, you notice the abdomen is asymmetrical, what may this indicate?
masses, adhesions, or strictures of underlying structures
34
When observing the abdomen, you noticed shadows what may this indicate?
bulges or masses
35
What does a bulge indicate?
tumors, cysts, or hernias
36
What does increased peristaltic activity indicate?
gastroenteritis or an obstructive process
37
During auscultation, what can you expect to hear in a normal pt?
irregular, high-pitches gurgling sounds
38
What do you hear when auscultating hyperactive bowel sounds?
loud, high-pitched and rushing
39
What do you hear when auscultating hypoactive bowel sounds?
slow and sluggish
40
Which pts produce hypoactive bowel sounds?
post-op or bowel obstruction or constipated
41
Which pts produce hyperactive bowel sounds?
diarrhea or gastroenteritis
42
What type of pts may have absence of bowel sounds?
paralytic ileus
43
During percussion, what is the normal sound?
tympany
44
Describe tympany
loud hollow sound
45
When percussing the intestines you hear hyperresonance, what may this indicate?
air-filled or distended
46
What are the causes of abdominal distention?
1. obesity
2. gaseous distention
3. ascites
4. abdominal tumor
47
Describe an abdominal tumor
abdomen is firm and dull to percuss
48
What type of distention is common in ovarian and uterine tumors?
abdominal tumors
49
What causes gaseous distention?
an increased production of gas on the intestines which occurs w. the ingestion os some foods
50
What do you hear when you percuss gaseous distention?
tympany over a lg area
51
What do you hear when you percuss ascites?
dullness in the lower abdomen
52
How do you assess a pt with ascites?
place the pt in a lateral position and observing fluid shift to the dependent side
53
What type of pts may develop ascites?
1. cirrhosis
2. CHF
3. nephrosis
4. peritonitis
5. neoplastic diseases
54
What are the hernias listed in the book?
1. umbilical
2. ventral (incisional)
3. Hiatal hernia
55
Describe an umbilical hernia
occurs when the abdominal rectus muscles separates or weakens allowing abdominal structures (usually intestine) to push through and come closer to the skin
56
Describe a hiatal hernia
weakening in the diaphragm allowing a portion of the stomach and esophagus to move into the thoracic cavity
57
Describe a ventral (incisional) hernia
occurs at the site of an incision when the incision weakens the muscle and the abdominal structures move closer to the skin
58
List the causes of ventral hernias
1. obesity
2. repeated surgeries
3. postop infxn
4. impaired wound
5. wound healing
6. poor nutrition
59
List some risk factors for pancreatic cancer
1. smoking
2. race
3. age
4. genetic disposition
60
What may you see in someone with pancreatic cancer?
1. extreme weight loss
2. jaundice
3. dark-colored urine
4. diarrhea
5. greasy, pale-colored stool
61
What you may see in someone with stomach cancer?
1. weight loss
2. vomiting
3. GI bleeding
4. cancerous lesions primarily located in the distal third of the stomach
62
What may you see in someone with hepatic cancer?
1. ascites
2. jaundice
3. vomiting
4. pale or white stool
63
Is Jon has pancreatic cancer what may he c/o of?
1. upper and middle to L quadrant abdominal pain that radiates to the back
2. Nausea
3. pruritis
64
If Lee has stomach cancer what may he c/o of?
1. indigestion
2. loss of appetite
3. sense of abdominal bloating after eating
4. nausea
4. abdominal pain
65
What person with hepatic cancer c/o of?
1. RUQ pain
2. bruising or bleeding easily
3. nausea
4. fatigue
66
What are SI/Sx of colorectal cancer?
1. rectal bleeding
2. unexplained weight loss
3. intestinal obstruction
67
What are some objective findings of colorectal cancer?
1. variation in bowel habits or elimination patterns
2. abdominal cramping or pain
3. fatigue
4. increased production of intestinal gas
68
What are some common GI inflammatory processes?
1. Crohn's
2. UC
3. Peritonitis
4. Esophagitis
4. Hepatitis
69
What are some causes of esophagitis?
1. ETHOL abuse
2. smoking
3. acid reflux
4. indigestion of hit and cold
70
What are Si/Sx of esophagitis?
1. vomiting
2. weight loss
3. esophageal obstruction
71
What are some objective findings of esophagitis?
1. dysphagia
2. chest pain
3. nausea
72
What does dullness indicate in the abdomen?
1. enlarged uterus
2. ascites
3. distended urinary bladder
73
What does dullness in the LLQ indicate?
presence of stool so ask when the pt had their last bm
74
When you percuss the liver what sound do you normally hear?
dull to percuss
75
While percussing the liver you hear dullness above the 5th or 6th ICS, what does this indicate? Explain
enlarged liver because the liver typically has an upper border in the 5th or 6th ICS.
76
What is the liver span?
measures distance between upper and lower border of the liver which is approx, 5-10 cm or 2-4in
77
How do you determine the movement of the liver?
ask the pt to take a breath and hold it
78
When you percuss the spleen, how do you know the pt has splenomegaly?
dullness is heard at the L anterior axillary line
79
What is referred pain?
abdominal pain from an organ that is felt on the surface of the abdomen or back
80
Which pts do you not palpate?
1. suspected appendicitis
2. abdominal aortic aneurysm
3. Polycystic kidneys
4. transplanted organs
81
Which part of the hand do your palpate the abdomen w/?
palmar surface
82
Can you palpate the spleen?
no
83
Describe Blumberg's sign
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
What is McBurney's Pt?
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
What is Rovsing's sign?
pain during palpation of the L lower abdomen
86
What does McBurney's pt and Rovsing's sign apply to?
appendicitis
87
What is the name of alt method to percuss for ascites?
shifting dullness
88
Describe how to shift dullness for ascites?
position the pt on R or L side and percuss
89
What is the purpose of Psoas sign?
when lower abdominal pain is present and you suspect appendicitis this exacerbates the pain
90
Describe how to do the Psoas sign?
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
How does the Psoas work?
flexion of the hip causes contraction of the psoas muscle
92
How to do the Murphy's sign?
while palpating the liver ask the pt to take a deep breath? the diaphragm descends pushing the liver and gallbladder toward your hand
93
In a healthy pt does palpating the liver hurt?
no
94
If the pt is positive for Murphy's sign what does this mean?
cholecysitis
95
Where and in what cases do you hear friction rub?`
LUQ and RUQ over the liver and spleen due to tumor or inflammation of the organ
96
List the inflammatory process discussed in the book
1. UC
2. Crohn's
3. esophagitits
4. peritonitis
5. Hepatitis
97
List the types of hepatitis
1. Hep A
2. Hep B
3. Hep C
4. Hep D
5. Hep E
98
How is hepatitis A transmitted?
fecal-oral
99
How is Hep B transmitted?
parenteral, sexually or periontonally
100
How is Hep C transmitted?
blood products
101
How is Hep D transmitted?
same as Hep B
102
How is Hep E transmitted?
enteral
103
List the types of hernias
1. umbilical
2. ventral
3. Hiatal
104
Describe a hiatal hernia
this occurs when the stomach and esophagus move into the thoracic cavity; can be rolling or sliding (adults> children)
105
How does someone get a ventral hernia?
1. repeated surgeries
2. obesity
3. impaired wound healing
4. poor nutrition
106
Describe an umbilical hernia
the rectus abdominus muscle weakens causing the protrusion of the intestines to become closer to the surface of the skin (children > adults
