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Physical Diagnosis > Abdomen > Flashcards

Abdomen Flashcards

1
Q 
Pain:
RUQ/epigastric pain
Epigastric pain
Periumbilical pain
Hypogastric pain
Suprapubic/sacral pain
A

RUQ/epigastric pain- biliary tree, liver
Epigastric pain- stomach, duodenum, pancreas
Periumbilical pain- small intestine, appendix, proximal colon
Hypogastric pain- colon, bladder, uterus
Suprapubic/sacral pain- rectum

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2
Q

Bowel movements - 3 factors

A

Frequency, consistency, pain

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3
Q

Bloody stools

A

Hematochezia

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4
Q

Black, tarry stools

A

Melena

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5
Q

White/gray stools

A

Indicative of liver/gallbladder disease

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6
Q

Urinary tract- 4 factors

A

Frequency, pain with urination, color, and smell

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7
Q

Back pain at the costovertebral pain

A

Kidney

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8
Q

In the abdomen, always _________ before ___________/_____________

A

Auscultate before palpating/percussing

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9
Q

Order for examination of the abdomen

A

Inspection, auscultation, percussion, palpation

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10
Q

Light palpation

A

Gentle. Identify any superficial organs/masses

Voluntary guarding or involuntary guarding

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11
Q

Deep palpation

A

Palpate deeply in the periumbilical area and both lower quadrants

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12
Q

Rebound tenderness

A

Occurs if pain increases when examiner decreases pressure against the abdomen

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13
Q

A sign which confirms the presence of peritonitis **** TQ!

In addition, will also find ________ and ________

A

Rebound tenderness

In addition,

  • rigidity
  • involuntary guarding
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14
Q

Peritonitis listen for

A

Friction rub over the liver/spleen

Borborygmus- rumbling bowel sound

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15
Q

RUQ structures

A

Gall bladder, liver, duodenum, R kidney, abdominal aorta

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16
Q

LUQ

A

Spleen, left kidney, pancreas, stomach

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17
Q

LLQ structures

A

Sigmoid colon, transverse and descending colon, bladder, uterus, ovaries

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18
Q

RLQ

A

Bowel loops, appendix at McBurney’s point, cecum

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19
Q

Hepatitis liver edge

A

6 cm below RCM

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20
Q

Rovsing’s sign

A

Palpation of LLQ increases pain felt in RLQ - acute appendicitis

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21
Q

Murphy’s sign

A

Places hand under R costal margin and patient inspires. If patient winces when in contact with liver- cholecystitis

22
Q

Normal bowel sounds

A

5-34 clicks and gurgles/minute

Borborgmi- stomach growling

23
Q

Abnormal bowel sounds

A

Bowel sounds increase if diarrhea, early intestinal obstruction

Decrease if obstruction, peritonitis

24
Q

Friction rub

A

Signifies infection. Heard over liver and spleen

25
Q

Succussion splash

A

Sloshing sound when patient moves from side to side. Listen while shaking abdomen from side to side

26
Q

Bruit

A

Heard with high blood pressure. Bruits heard with systolic and diastolic indicate arterial occlusion/insufficiency. Suggest narrowing of the vessel. Listen over abdominal aorta and renal arteries

Can suggest liver cancer or alcoholic hepatitis

27
Q

Liver percussion & palpation

A

Liver size 6-12 cm

Resonance to dull- top
Tympanic to dull- bottom

Palpable during inhalation

28
Q

Spleen- percussion & palpation

A

Not percussable/not palpable

Tympanic- normal
Dull- enlarged spleen (dull = organs)
Palpate during inhalation

29
Q

Kidney palpation

A

Place below 12th ring. One had back and above. Check on exhalation

30
Q

Aorta

A

Press firmly in abdomen slightly L of midline to identify aortic pulsation

31
Q

Iliopsoas test (psoas test)

A

R hip flexion against physician’s resistance. Positive indicates abdominal pain & inflamed appendix

32
Q

Obturator test

A

R hip flexion, R knee flexion, internal rotation. Positive indicates R hypogastric pain and inflamed appendix

33
Q

Bloody/pink-ish hematuria

A

Kidney stones, UTI, tumor, STI

34
Q

Reddish urine

A

Beets

Medication

35
Q

Dark urine

A

Impaired excretion of bilirubin to GI tract

36
Q

Pale colored stools

A

Alcoholic stools

Bile not entering intestine due to blockage

37
Q

Abdominal involuntary rigidity

A

Involuntary muscle spasm

Peritoneal inflammation

38
Q

Abnormal palpating liver findings

A

Bluntness or rounding of edge

Irregular contour

39
Q

Pallor

A

Pale skin

40
Q

Jaundice

A

Yellow skin

41
Q

Peripheral cyanosis

A

Blue around extremities

42
Q

Central cyanosis

A

Blue around face, lips and tongue

43
Q

Causes of kidney enlargement

A

Cysts, tumors, hydronephrosis

44
Q

CVA tenderness

A

Pyelonephritis - infection of kidney/ureters

45
Q

Dysphasia

A

Esophageal dysphagia- mucosal rings, esophageal stricture, cancer

Motor disorders- esophageal spasm, scleroderma, achalasia

46
Q

Constipation

A

Life habits, IBS, mechanical obstruction, painful anal lesions, drugs, depression, metabolic conditions

47
Q

Ascites

A

Cirrhosis, CHF, pericarditis, IVC, Hepatic vein obstruction

48
Q

Abdominal aortic aneurysm

A

Periumbilical mass.

Expansive pulsation 3 cm or more

49
Q

Osteopathic viscera-somatic reflexes with abdominal/GI disorders

  • stomach
  • spleen/pancreas
  • liver/gb
  • SI
  • kidney
  • Right colon
  • Left colon
A
  • stomach- T5-T9 Left
  • spleen/pancreas- T7-T9 left
  • liver/gb- T6/7-T9 Right
  • SI- T9-T10
  • kidney- T10-L1
  • Right colon- T10-T11 Right
  • Left colon - T12-L2 left
50
Q

Liver edge in normal vs acute hepatitis patients

A

Non-tender 1 finger-breadths below RCM

Tender 4-5 finger-breadths below RCM

Physical Diagnosis (6 decks)

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