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Clinical Medicine Midterms > Abdomen Trans Part 3 > Flashcards

Abdomen Trans Part 3 Flashcards

1
Q

Normally the bladder capacity is

A

400-500 ml

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2
Q

Leakage of urine due to increase intra abdominal pressure

Occur in coughing, laughing, exercise, lifting heavy objects

A

Stress incontinence

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3
Q

Stress incontinence appears in women when

A

Weakness of bladder and proximal urethra
Anatomic damage to urethral sphincter
Urethral infection
Post menopausal atrophy

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4
Q

Stress incontinence appears in men when?

A

After prostatic surgery

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5
Q

Inability to hold urine once the urge to void occurs

Detrussor contraction stronger than the normal urethral resistance

A

Urge incontinence

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6
Q

Urge incontinence due to

A

Decrease cortical inhibition of Detrussor contractions
Hyper excitability of sensory pathways
Deconditioning of voiding reflexes

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7
Q

Urge incontinence

Hyper excitability of sensory pathways caused by

A

Bladder infection
Fecal impaction
Tumors

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8
Q

Urge incontinence

Deconditioning of voiding reflexes caused by

A

Frequent voluntary voiding at low bladder volume

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9
Q

Type of urge incontinence caused by uninhibited bladder contraction

A

Reflux incontinence

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10
Q

Mechanical dysfunction resulting from. An over distended bladder

A

Overflow incontinence

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11
Q

Detrussor contractions are insufficient to overcome urethral resistance

A

Overflow incontinence

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12
Q

Overflow incontinence

Describe bladder

A

Typically large even after a effort void

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13
Q

A continous dripping or dribbing incontinence

Enlarged distended bladder is often found on PE

A

Overflow incontinence

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14
Q

Overflow incontinence

Due to

A

Obstruction of the bladder outlet as in prostatic enlargement
Weakness of the Detrussor muscle ( multiple sclerosis, spinal cord lesion)
Impaired bladder sensation that interrupts the reflex (FM neuropathy)

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15
Q

With intact urinary tract

A

Functional incontinence

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16
Q

Functional incontinence

Due to

A

Cognitive disabilities
Immobility
Musculoskeletal diseases
Environmental factors

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17
Q

Drugs may contribute to any type of incontince

A

Incontinence secondary to medication

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18
Q

Incontinence secondary to medication

Includes

A 
Sedative
Tranquilizers
Anticholinergics
Potent diuretics
Symphatetic blockers
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19
Q

Combinations of the different types of incontinence

A

Mixed incontinence

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20
Q

Bladder is unable to empty

A

Urinary retention

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21
Q

Urinary retention

Due to

A

Mechanical obstruction of bladder outflow

Loss of Detrussor strength

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22
Q

Urinary retention

Painful differentiating it from other causes of oliguria/anuria

A

Acute

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23
Q

Urinary retention

Develops gradually and is painless. The only symptom may be frequent and is painless. The only symptom may be frequent urination of small amounts or overflow incontinence.

A

Chronic urinary retention

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24
Q

It measure the adequacy of bladder emptying

It determine the volume of urine remaining in the bladder after full voluntary voiding

A

Determination of post void residual urine volume

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25
Q

Post residual volume can be measured by

A

Bladder UTZ

Catheterization

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26
Q

Significant residual urine volume is

A

> 100ml

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27
Q

Inspection

Note for size

A

Abdominal circumference

Level of umbilicus

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28
Q

Inspection

Shape

A

Contour - from the rib margin to the pubis
Viewed on horizontal plane
Describe as flat, rounded, globular or scaphoid

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29
Q

Inspection

Symmetry

A

Note for localized distention or bulges

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30
Q

Inspection

Abdominal distention

Six F’s

A 
Fat
Fluid
Feces
Fetus
Flatus
Fatal growth
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31
Q

Inspection

Abdominal distention

Result from excessive caloric intake or redistribution of adipose tissue caused by hormonal factors.

A

Obesity

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32
Q

Obesity

Abdomen

A

Round with increase in girth

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33
Q

Obesity

Buried deeply on the wall

A

Umbilicus

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34
Q

Obesity

Usually evident in other parts of the body

A

Excess fat

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35
Q

Inspection

Result from accumulation of peritoneal fluid

A

Ascites

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36
Q

Ascites thru the ff mechanism

A

Transduction of fluid from splanchnic circulation
Eg. Portal HPN

Obstruction of lymphatic drainage of the peritoneum
Decrease plasma oncotic pressure
Eg. Liver cirrhosis and nephritic syndrome

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37
Q

Dullness shifts to the more dependent site, while tympani shifts to the top.
Dependent fluid causes an area of dullness in the lowest part, this shift to remain lowest with changes in position of the body

A

Shifting dullness

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38
Q

A wave in the fluid, elicited by tapping one side of the abdomen, is transmitted to the receiving hand on the opposite side.
The wave takes penceptible time to cross the abdomen

A

Fluid wave

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39
Q

Present with as little as 120 ml of peritoneal fluid

Position patients on hands and knees allowing fluid to accumulate on dependent part of the abdomen

A

Puddle sign

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40
Q

Place stethoscope at this area and listen for the sound made by flicking the side of the abdomen with finger

A

Puddle sign

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41
Q

Puddle sign

Repeated while stethoscope is moved farther away, the sounds become louder

A

Flicking

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42
Q

Accumulation of large amount of feces seen in

A

Mega colon
Disorder of myenteric plexus
Advanced age
Anticholinergic drugs

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43
Q

Masses of feces can often be palpated through

A

Abdominal wall

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44
Q

Rectal exam show stool in the

A

Rectal vault

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45
Q

Associated findings in pregnancy during inspection

A 
Breast are engorged
Fetal movement maybe felt
Parts of fetus are palpable
Cervix is softened
Fetal heart should be audible
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46
Q

Presence of excessive gas within the bowel or free in the peritoneal cavity

A

Tymphanities

47
Q

Tymphanities

Seen in

A

Intestinal obstruction ileus

48
Q

Tymphanities

Physical sign

A

Abdominal distention

Large area of tymphany

49
Q

Tymphanities

Increase force of peristaltic contraction proximal to the obstruction

A

Colic

50
Q

Tymphanities

Proximal bowel distention by retained luminal contents leading decompression

A

Vomiting

51
Q

Tymphanities

Present when obstruction is

A

Distal to the mid-jejunum

52
Q

Increase peristalsis is proximal to an obstruction is indicated by

A

Frequent, loud peristaltic sounds (borborygmi) accompanied by cramping, colicky pain.

53
Q

Epigastric pain is intense
Vomiting early and severe
Abdominal distention appears late and limited to epigastirum

A

Proximal small intestinal obstruction

54
Q

Symptoms are less severe
Vomiting is delayed
Vomitus may have become feculent
Diffuse abdominal distention gradually develop

A

Distal small intestinal obstruction

55
Q 
Abdominal pain is less
Vomiting is late
Vomitus may be feculent
Constipation is invariable
Prominent abdominal distention
A

Colonic intestinal obstruction

56
Q

Localized bowel obstruction causing increased force of peristaltic contraction proximal to the obstruction

A

Noisy tymphanities with colic and vomiting (mechanical obstruction)

57
Q

Diffuse decreased in bowel motility and muscular tone, producing a silent abdomen with distended bowel.

A

Silent thympanies without colic or vomiting (ileus)

58
Q

Silent thympanies without colic or vomiting (ileus)

Peristaltic sounds are

A

Diminished or absent

59
Q

Silent thympanies without colic or vomiting (ileus)

Only mild abdominal pain,

A

Colic is absent

60
Q

Silent thympanies without colic or vomiting (ileus)

Etiology

A 
Inflammatory disease
Infectious
Metabolic/toxic
Mechanical/trauma
Neurologic
Vascular
61
Q

Small amount of gas i peritoneal cavity cannot be identified by. PE

A

Tympanities without ileus

62
Q

Tympanities without ileus

Only found by x-ray findings of free air beneath the diaphragm

A

In upright position

63
Q

Skin

A

Color/discoloration
Lesions
Scars
Blood vessels

64
Q

Color / Discoloration

Also called icterisia/icterus
Yellow discoloration of the skin and sclera resulting from deposition of bilirubin

A

Jaundice

65
Q

Color / Discoloration

Jaundice

Visible when conjugated bilirubin is

A

> 2mg/dL

66
Q

Color / Discoloration

Jaundice

Associated findings

A

Pruritus
Dark yellow to brown urine
Acholic feces

67
Q

Hepatocellular conditions that may produce jaundice

Hepa
EBV
CMV
Herpes

A

Vital hepatitis

68
Q

Hepatocellular conditions that may produce jaundice

Drug toxicity

A

Predictable, dose dependent (acetaminophen)

Unpredictable, idiosyncratic (isoniazid)

69
Q

Hepatocellular conditions that may produce jaundice

Environmental toxins

A

Wild mushrooms- amantia phalliodes or A. VERNA

70
Q

Hepatocellular conditions that may produce jaundice

Others

A

Wilson disease
Autoimmune hepatitis
Alcohol

71
Q

Faintly blue coloration in the umbilicus

Result from hemoperitoneum (acute hemorrhagic pancreatitis)

A

Cullen’s sign

72
Q

Blue red, blue purple, or green brown
Noted on the skin of lower abdomen and flanks
Caused by massive non-traumatic ecchymoses

A

Grey turner’s sign

73
Q

Pink purple striae

A

Cushing syndrome

74
Q

Striae usually locate on

A

Flanks or lateral aspect of abdomen

75
Q

Striae may also be areas under chronic lesions as

A

Shoulder
Thighs
Breast

76
Q

Striae etiology

A 
Obesity
Pregnancy
Ascites
Subcutaneous edema
Cushing's syndrome
77
Q

Fiery red in color

Central body surrounded by erythema and radiating legs

A

Spider Angiomas

78
Q

Spider angioma noted in

A

Abdomen, face, arms, neck

Result : chronic liver disease

79
Q

Spiderangiomas

Results

A

Chronic liver disease
Vit. b deficiency
Pregnancy

80
Q

Spider Angiomas kinds

A

Surgical scars

  • with suture marks
  • smooth
81
Q

Spider Angiomas kinds

Usually jagged edges
Full thickness burns causes deep, irregular, broad, and un elastic scars

A

Traumatic scars

82
Q

Are scars that heal with raised, red, hypertrophic tissues that may progressively thickens overtime

A

Keloid

83
Q

Present as tufts of engorgred abdominal veins radiating from the umbilicus
Resembles a nest of snakes

A

Caput medusa

84
Q

Sing of increased intra abdominal pressure as in ascites and intra abdominal mass

A

Everted umbilicus

85
Q

Irregular nodules as exfoliation after completely replacing the umbilicus
Signifies metastasis from intra-abdominal malignancy

A

Sister Mary Joseph nodules

86
Q

May have discharges

  • urine through patent urachus
  • pus from urachal cyst or abscess in abdominal cavity
A

Umbilical fistula

87
Q

A hard mass with dirt and desqumated epithelium that accumulate in umbilical cavity and cause inflammation

A

Umbilicus calculus

88
Q

Indicative of paralysis or weakening of the diaphragm

A

Respiratory paradox

89
Q

Also sign of respiratory muscle weakness and lead to respiratory failure

A

Respiratory alterans

90
Q

Abdominal wall may remain immobile during respiration

Diffuse or localized

A

Peritonitis

91
Q

Abdomen moves with respiration synchronized with the chest wall

A

Abdominal respiratory motion

92
Q

Normally abdominal aorta causes slight pulsations in the epigastirum

A

Visible pulsations

93
Q

In the abdominal wall, normal contractions of stomach and intestines maybe visible

A

Visible peristalsis

94
Q

Abdominal separation of abdominal rectus muscles

Became apparent only when patient raises his head from examining table

A

Diastasis recti

95
Q

Protrusions of abdominal contents through a weak point in the abdominal wall

A

Abdominal hernias

96
Q

Abdominal hernias

If contents can be easily pushed back into abdomen

A

Reducible

97
Q

Abdominal hernias

When blood supply of incarcerated contents is interrupted

A

Strangulated

98
Q

Abdominal hernias

Types

Hernia which protrude in the area of surgical scars

A

Incisional hernia

99
Q

Abdominal hernias

Types

Strangulation of part of the circumference of gut wall

A

Ritchter hernia

100
Q

Abdominal hernias

Types

Consist of preperitoneal fat protruding outward between the fibers of linea alba

A

Epigastric hernia

101
Q

Abdominal hernias

Types

Defect in abdominal fascia occurs normally where umbilical exit the abdomen

A

Umbilical hernia

102
Q

Umbilical hernia two types

A

Congenital

Adult

103
Q

3 signs of ovarian cyst

A

Abdominal profile reveals 2 curves instead of one
Ruler test
Supine position

104
Q

Loud rumbling and gurgling sounds resulting from a rush of gas fluid through the lumen of GIT

A

Borborygmi

105
Q

Types of bowel sound

Soft or loud, low pitch
5-30/min
Bowel sound occur every 5-15 seconds

A

Normo active bowel sounds

106
Q

Types of bowel sound

> 30 or + bowel sounds every 2 seconds
Continous and loud

A

Hyperactive bowel sounds

107
Q

Types of bowel sound

A

Hypoactive bowel sounds

108
Q

Types of bowel sound

No bowel sound after 5 minutes of auscultation

A

Absent bowel sound

109
Q

Causes of hyperactive bowel sounds

A

Diarrhea
Early pyloric obstruction
Early intestinal obstruction
Drugs (laxative)

110
Q

Indicates turbulent flow in a dilated, constricted, or tortuous artery

A

Arterial bruits

111
Q

Should be noted in patient with: hepatocellular carcinoma
AV malformation
Alcoholic hepatitis

Heard over the RUQ

A

Hepatic bruit

112
Q

Yung palpation, auscultation at percussion

A

Hindi na gagawan ng BS may recalls naman yun eh

113
Q

Involuntary loss of urine

A

Urinary incontinence

Clinical Medicine Midterms (6 decks)

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