Abdomen

Question 1

What should you check for in inspection at the beginning of a respiratory exam?

Answer 1

catheter, stoma, distension, nutrition, medication, alcohol, surgical drains, general appearance of health

Question 2

What should you look for on the hands in a abdomen exam?

Answer 2

temperature, sweat, jaundice, palmar erythema, clubbing, pitting of finger nails, spooning/korinicola, capillary refill, pulse, liver flap

Question 3

What disease can cause putting if the nails?

Answer 3

Psoriasis

Question 4

What is the most common cause of nail spooning/koilonychia?

Answer 4

Iron deficiency anaemia

Question 5

What signs should be looked for in the eyes in a abdomen exam?

Answer 5

jaundice in the sclera, pallor of the conjunctiva, kayser-fleischer rings, xanthalamas

Question 6

At what bilirubin levels does an icteric sclera occur?

Answer 6

2mg/dL

Question 7

In what disease do Kayser-Fleischer rings occur?

Answer 7

Wilson’s

Question 8

What is xanthalamas indicative of?

Answer 8

Hyperlipidaemia

Question 9

What signs should be looked for in the mouth in a abdomen exam?

Answer 9

general colour, ulceration, halitosis, pale under tongue, angularscamatus, glottis

Question 10

What is halitosis?

Answer 10

Bad breath

Question 11

What is angular stomatitis?

Answer 11

a common inflammatory condition affecting the corners of the mouth or oral commissures

• aka angular cheilitis

Question 12

What are the common causes of angular stomatitis?

Answer 12

nutritional deficiencies, especially of the B vitamins and iron

Question 13

Evidence of iron and B vitamin deficiencies are common first manifestations of what disease?

Answer 13

Malnutrition and/or malabsorption diseases

Question 14

What should you check for on the neck in an abdomen exam?

Answer 14

Raised JVP, not very good though, and Verkauf’s lymph nodes

Question 15

How must a patient be positioned in an abdomen exam?

Answer 15

Flat with the hands by their side

Question 16

What should be looked for on close inspection of the abdominal region?

Answer 16

scars front and back, ascites, distension, striae, spider naevi, veins, capful medusae, cherry hemangeonas/red dots/Campbell de Morgan spots, hernias, abdominal aorta

Question 17

What is capital medusae and where can it be seen?

Answer 17

• the appearance of distended and engorged superficial epigastric veins
• radiates from the umbilicus across the abdomen

Question 18

What should be palpated on the abdomen?

Answer 18

generalised light palpation followed by deep main organs, liver, spleen, kidneys, aortic pulse

Question 19

How can the spleen be distinguished from the liver on palpating?

Answer 19

There is a palpable notch on the spleen where the ‘lobes’ meet

Question 20

What is the difference between a normal and AAA on palpation?

Answer 20

• normal = pulsatile

- AAA = expansile, it will move your hands out of the way

Question 21

What should be percussed for on the abdomen?

Answer 21

Liver borders, spleen, shifting dullness

Question 22

What should be auscultated for on the abdomen?

Answer 22

General bowels sounds, bruits

Question 23

Where should general bowel sounds be auscultated for?

Answer 23

The lower right quadrant due to the ileocaecal valve

- if it cannot be heard here then listen somewhere else until it has been heard

Question 24

What are bruits?

Answer 24

Abnormal blood flow

Question 25

Where are bruits listened for in an abdominal exam?

Answer 25

Just above the umbilicus and then 2.5cm from it in the corners

Question 26

What is the significance of where bruits are listened for in an abdominal exam?

Answer 26

Rental and iliac artery branches

Question 27

What extras should be done at the end of an abdominal exam?

Answer 27

history, basic obs, hernias, testicular exam, PR, stool sample, urine dip and scans plus blood test

Question 28

Where is Verkauf’s lymph node found?

Answer 28

In the subclavian depression

Question 29

What does an enlarged Verkauf’s lymph node suggest?

Answer 29

Upper abdominal malignancy