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Physical Diagnosis > AbdomenPhysicalExam > Flashcards

AbdomenPhysicalExam Flashcards

1
Q

effortless reflux of digestive enzymes & stomach contents into the mouth

A

regurgitation

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2
Q

forceful expulsion of stomach contents out of the mouth

A

vomiting

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3
Q

recent, ongoing bleeding or blood-stained vomit

A

hematemesis

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4
Q

associated with bile from the intestines ending up in the stomach through an incompetent pyloric sphincter

A

yellow vomit

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5
Q

what causes coffee grounds emesis

A

gastric blood that has been coagulated & oxidized by stomach acids and looks like “coffee grounds” floating in vomit

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6
Q

steps in producing the normal, brown colored stool

A
  1. spleen breaks down old & damages RBC’s to produce bilirubin (unconjugated)
  2. liver further processes bilirubin and excretes it with bile (conjugated)
  3. Colon bacteria & oxidation convert biliruin to stercobilin which turns stools brown.
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7
Q

Black, tarry foul smelling stools

A

melena

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8
Q

stool type results from bleeding higher in the gastrointestinal tract

A

black stools (melena)

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9
Q

gray or yellow stools

A

steatorrhea

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10
Q

what could cause steatorrhea

A

impaired liver function or bile output blockage, malabsorption of fat

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11
Q

possible conditions that cause steatorrhea (5)

A
  • hepatitis
  • cirrhosis
  • chronic pancreatitis
  • cholecystitis
  • gall stones
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12
Q

blood streaked stools

A

hematochezia

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13
Q

bleeding in the lower GI tract leads to which kind of stool

A

hematochezia

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14
Q

common causes of hematochezia (3)

A
  • anal fissure
  • hemorrhoids
  • polyps
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15
Q

a combination of blood, mucus, and feces

A

currant jelly stools

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16
Q

currant jelly stools are associated with which condition

A

intusseception

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17
Q

dark yellow and orange urine is usually due to what

A

dehydration

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18
Q

common causes of hematuria

A

UTI’s and kidney stones

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19
Q

what causes tea colored urine

A

impaired liver function or bile output blockage which forces bilirubin to be excreted in the urine rather than in the bile

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20
Q

a yellow pigment that gives a bruise, urine & jaundiced skin the yellow color

A

bilirubin

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21
Q

symptoms suggesting GI problems

A
  • difficulty swallowing
  • loss of appetite
  • indigestion
  • nausea and vomiting
  • abdominal pain
  • diarrhea
  • constipation
  • discolored stools or urine
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22
Q

symptoms suggesting a GU problem

A
  • painful urination
  • increased, decreased or absence in frequency of urination
  • discolored urine
  • discharge
  • hesitancy or diminished flow
  • infertility or other sexual concerns
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23
Q

symptoms suggesting gynecologic problems

A
  • pain before, during, or after menstruation
  • heavy, light, or absent menstrual flow
  • vaginal discomfort or discharge
  • infertility or other sexual concerns
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24
Q

organs in the RUQ

A
  • HEPATIC flexure of colon
  • liver
  • gallbladder
  • right adrenal gland
  • right kidney
  • SI
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25
Q

organs in the LUQ

A
  • SPLENIC flexure of colon
  • stomach
  • body of the pancreas
  • spleen
  • left adrenal gland
  • left kidney
  • SI
  • abdominal aorta
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26
Q

organs in the LRQ

A
  • cecum and appendix
  • right ovary and fallopian tube
  • right ureter
  • small intestines
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27
Q

organs in the LLQ

A
  • sigmoid colon
  • left ovary and fallopian tube
  • left ureter
  • small intestines
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28
Q

organs of the suprapubic region

A
  • penis and testicles
  • urinary bladder and urethra
  • vagina and uterus
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29
Q

rule-of-thumb which states that further away from the navel a pt points to an area pain more likely it is organic in nature

A

apley’s rule

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30
Q

irritation to the underside of the diaphragm may refer pain to where

A

shoulder

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31
Q

abdominal pain that radiates to the left shoulder

A

kehr’s sign

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32
Q

underlying problems in abdomen that cause kehr’s sign

A
  • splenic rupture
  • kidney stone
  • ectopic pregnancy
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33
Q

intestinal pain usually has which pattern

A

wave like pattern

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34
Q

pain that originates in solid organs has which pattern

A

constant pain, depending on how frequently the organ is distended

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35
Q

Exam procedures of the abdomen are typically performed in which order

A
  • inspection
  • auscultation
  • percussion
  • light and deep palpation
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36
Q

patient placement while performing an abdominal exam

A

supine on table draped with abdomen exposed from xiphoid to pubic hair line with arms by sides and knees bent to relax the abdominals

37
Q

inspection portion of the abdominal exam

A
  • skin tone and texture
  • contour
  • pulsations
  • peristalsis
38
Q

cyanosis around the umbilicus

A

cullen’s sign

39
Q

cullen’s sign indicates what

A

intra-abdominal hemorrhage

40
Q

varying degrees of abdominal distension result from what

A

the 9 F’s

  • fat
  • fetus
  • full bladder
  • feces
  • flatus
  • fluid
  • fibroids
  • fatal tumor
  • false pregnancy
41
Q

accentuated epigastric pulsations greater than 2” in diameter or a pulsating mass suggests

A

abdominal aortic aneurysm

42
Q

is it normal for peristaltic movements to be visible

A

no

43
Q

when peristaltic movements are visible, indicates

A

intestinal obstruction

44
Q

points you should auscultate during an abdominal exam; listen for abnormal bowel, vascular and friction rub

A
  • aortic
  • hepatic and splenic
  • renal
  • iliac
  • femoral
45
Q

what can cause increased frequency of bowel sounds

A
  • hunger
  • diarrhea (gastroenteritis)
  • intestinal irritants (Crohn’s disease, ulcerative colitis)
  • first 24 hours of an intestinal obstruction
46
Q

what can cause decreased frequency of bowel sounds (no sounds heard for 2 minutes)

A
  • opiates
  • coming out of anesthesia
  • coming out of abdominal surgery
  • undergoing abdominal cancer radiation therapy
  • intussusception (dance sign)
47
Q

dance sign indicates what

A

intussusception

48
Q

absence of sounds in the LRQ

A

dance sign

49
Q

what can cause a bruit

A
  • stenosis
  • compression
  • aneurysm
50
Q

friction rubs in the abdomen suggest

A

inflammation of the peritoneal surface of an organ

51
Q

venous hums in upper quadrants of abdomen suggest

A

increased collateral circulation between the portal and systemic venous system

52
Q

percussive notes heard over a normal abdomen

A

tympanic with occasional dull notes

53
Q

large areas of dullness indicate when heard in the abdomen while performing percussion

A
  • enlarged organ
  • tumor
  • fluid in abdomne
    (feces and full bladder are commonly mistaken for masses)
54
Q

when percussing along the right mid clavicular line, when would you hit the inferior border of the liver

A

no more than 1/2” below the costal margin

55
Q

where you percuss if looking for the spleen

A

from 6th - 10th ribs just posterior to the mid axillary line

56
Q

where you percuss if looking for gastric air bubble (stomach)

A

left 6th - 7th intercostal space

57
Q

what note would the gastric air bubble give

A

tympanic

58
Q

tympanic note heard above diaphragm with recurrent heartburn, indicates

A

hiatal hernia

59
Q

deep palpation during an abdominal exam

A
  • lower liver border
  • spleen enlargement
  • kidneys enlargement
  • signs of aortic aneurysm
60
Q

localized abdominal tenderness is reported or detected during deep palpation you should focus your palpation to those areas to find the source of the problem

A

FALSE; those areas should be avoided until other areas have been assessed

61
Q

lumpy liver border suggest

A

liver cancer

62
Q

hard liver border suggest

A

cirrhosis of the liver

63
Q

tender liver border suggest

A

hepatitis

64
Q

tender mass in right midclavicular line suggests

A

cholecystitis

65
Q

where is McBurney’s point

A

half way between the navel and the right ASIS

66
Q

percussion at McBurney’s point causes discomfort in epigastric area

A

aaron’s sign

67
Q

positive aaron’s sign indicates

A

appendicitis

68
Q

cutaneous hypersensitivity to light stimulation at McBurney’s point suggests

A

appendicitis

69
Q

having pt lift their head when supine contracts abdominal muscles; if pain is diminished when lift head it indicates

A

pain is coming from a deeper source

70
Q

having patient lift their head when supine position contracts the abdominal muscles. if pain doesn’t go away when they lift their head it indicates

A

the pain is coming from a superficial source

71
Q

eliciting a rebound tenderness is a positive ______ sign and is a means of irritating an intestinal structure and overlying peritoneum without poking directly on a potentially infected structure.

A

blumberg’s

72
Q

if rebound tenderness is felt in the LRQ

A

McBurney’s sign and indicates appendicitis

73
Q

If palpation (not rebound) in LLQ causes pain in LRQ it is a positive ______ sign

A

Rovsing

74
Q

positive Rovsing sign suggest

A

appendicitis

75
Q

resistance of your hand

A

iliopsoas muscle test

76
Q

positive iliopsoas muscle test indicates

A

appendicitis

77
Q

with pt supine lift right thigh off the table and rotate the leg in and out by holding the ankle

A

obturator muscle test

78
Q

positive obturator muscle test (pain when rotate ankle) indicates

A

appendicitis

79
Q

have patient raise up on their toes and drop to their heels

A

markle’s heel drop sign

80
Q

least specific sign for appendicitis

A

markle’s heel drop sign

81
Q

Place flat hand over lower right ribcage and tap the hand with the closed-fist, knife-edge of the opposite hand

A

fist percussion

82
Q

first percussion aggravates original pain it suggests

A

hepatitis or cholecystitis

83
Q

Place thumb under right ribcage in area of gallbladder, have patient inhale, cessation of inspiration because of increased pain

A

Murphy’s sign

84
Q

murphy’s sign indicates

A

cholecystitis or gallbladder cancer

85
Q

ways to detect ascites (abnormal intraperitoneal fluid) by physical exam

A
  • fluid wave test
  • shifting dullness
  • puddle sign
86
Q

which and where are fingers positioned during zieman’s tridigital hernia examination

A
  • ring finger over the femoral triangle
  • middle finger over the external inguinal ring
  • index finger over the internal inguinal ring
87
Q

If the liver edge can be felt it should be

A

smooth, firm & not tender

88
Q

A strong, expansile aortic pulse greater than 1 inch in diameter during deep palpation suggests

A

abdominal aortic aneurysm (AAA)

89
Q

____ are more accurate at detecting ascites

A

sonograms

Physical Diagnosis (8 decks)

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