abdomen Flashcards
general inspection of the abdomen
- scars - laparoscopy scars
- masses - hernia, kidney transplant
- distention
- spider naïve on the chest
- tenderness, guarding, rebound
things to ask for
- ask if there is any pain and if there is pain then start furthest away from the pain
- when palpitating for the liver comment on how far below the costal margin it is in finger breathes or cm, comment on whether it was tendon or pulsate
- report the liver span from intercostal space to intercostal space,
- say bowel sounds are present If you can’t hear them right away, comment that you would continue
auscultating until bowel sounds are heard
“Abdominal aorta is pulsatile, but not expansile, which is normal.”
when do you start when percussing for liver borders
- start around the 3rd intercostal space, midclavicular line and percuss down until you here dullness this is usually the 5th intercostal space
when do you begin when palpitating for the spleen
a. Begin in the right iliac fossa so you do not miss a giant spleen.
where does the spleen lie
c. The spleen lies under ribs 8-11th and is posterior to the mid-axillary line.
what would you further test
check hernia orifices,
examine external genitalia and perform a digital rectal exam
where does the subcostal plane lie (horizontal lines)
The subcostal plane lies at the lowest point of the costal margin seen from the front i.e. below the 10th rib (L1).
where does the trans tubercular plane ( horizontal lines)
The transtubercular plane is the highest point of the pelvis seen from the front i.e. joining the two iliac tubercles. Some use the level of the iliac crests, which is a little higher, or of the ASIS which is a little lower.
where are the vertical divisions of the 9 planes
- mid clavicular lines
- half between ASIS and the pubic symphysis - the mid inguinal point
where is the umbilicus
- corresponds to L3/L4/L5 of the cerebral column
where is the transpyloric plane
The Transpyloric plane (L1 – IMPORTANT ANATOMY HERE!!) half way
between the sternal notch and the pubic symphysis OR Xiphi & Umbilicus
how do you accentuate the rectus abdomens muscle
Accentuate this by doing a “sit-up” and note
its relation to the costal margin
what crosses the trans-lyric plane
Fundus of Gallbladder
Pylorus
Neck of Pancreas
Origins of SMA & Hepatic Portal V Duodenum (1st or 4th part) * Kidneys – Lt Hylum, Rt upper pole
where does the lateral edge of the rectus abominis muscle met the costal margin
he lateral edge of the muscle meets the costal margin at the tip of the 9th rib
what is an alternative way of defining the transpyloric plane
getting them to do a sit up and looking at the rectus abdominis muscle
