Abdominal Flashcards
Types of Pain
Visceral Pain
Parietal Pain
Referred Pain
Pain
- _____ – poorly defined and intermittent; dull, aching, burning, cramping, or colicky (distended intestines, capsules of liver or spleen is stretched).
- _____ – localized; more severe and steady.
- _____ – traveling pain; primary site to distant site
- Visceral Pain
- Parietal Pain
- Referred Pain
Physical Assessment SEQUENCE:
IAPP
Inspection
Auscultation
Percussion
Palpation
Purple discoloration of the abdomen flanks due to bleeding within the abdominal wall
GREY TURNER’S SIGN
enlarged and distended superficial veins radiating from the umbilicus across the abdomen.
One of the cardinal signs of portal hypertension
Caput medusae
Common sign of liver disease; Dilated surface arterioles and capillaries with a central star.
Spider angioma (spider nevus)
wide, dark bluish- pink striae (_____)
Cushing syndrome
Periumbilical ecchymosis due to intra-abdominal bleeding.
CULLEN’S SIGN
What are the 6 F’s (Including the 7th)
Fat
Feces
Fetus
Fibroids
Flatulence
Fluid
FATAL TUMOR
Maybe seen with organ enlargement, masses, hernia (protrude muscles), diastasis recti, or bowel obstruction.
Abdominal asymmetry
Waves of peristalsis sometimes are visible in very thin people.
Bowel sounds systematic progression
RLQ-RUQ-LUQ-LLQ.
auscultating bowel sounds
A series of intermittent, soft clicks and gurgles are heard at a rate of 5–30/minute.
“_____”/stomach growling
borborygmus
“_____” bowel sounds that are rushing, tinkling, and high pitched.
(rapid motility in EARLY BOWEL OBSTRUCTION, gastroenteritis, diarrhea, or with use of laxatives.
Hyperactive
“_____” bowel sounds indicate diminished motility.
(paralytic ileus secondary to abd sx, peritonitis, or LATE BOWEL OBSTRUCTION)
Hypoactive
Basic Science
Sound waves are better conducted through a solid medium than through an air-filled medium because of the increased concentration of molecules.
- The more solid a structure, the higher its pitch, the softer its intensity, and the shorter its duration.
- The more air-filled a structure, the lower its pitch, the louder its intensity, and the longer its duration.
Types of Percussion
IMDI
1. Immediate
2. Mediate
3. Direct Fist
4. Indirect Fist
- _____ – Tapping directly on the body surface with fingers to assess underlying structures.
- _____ – Striking a finger placed on the body to produce sounds that indicate the condition of deeper tissues.
- _____ – Gently hitting the body with the side of a clenched fist to check for pain or tenderness.
- _____ – Placing one hand over the body and striking it with a fist to detect organ inflammation or tenderness.
- Immediate Percussion
- Mediate Percussion
- Direct Fist Percussion
- Indirect Fist Percussion
The midclavicular liver span is expected to be _____ cm Liver span correlates with body size and gender; large people and men tend to have larger spans.
6 to 12 cm
The midcsternal liver line span is expected to be _____ cm.
4-8 cm
The normal liver is identified as an area of dullness to percussion over the right anterior chest between the fifth rib and the costal margin.
Liver - Dull
Lungs - Resonance
Enlargement of the liver due to tumors, cirrhosis, abscess, vascular engorgement
HEPATOMEGALY
_____ position – may be caused by emphysema.
_____ position – abd mass, ascites, paralyzed diaphragm.
Lower Position
Higher Position
With the patient lying supine, begin percussing posterior to the left midaxillary line (MAL), and percuss downward, noting the change FROM LUNG RESONANCE TO SPLENIC DULNESS.
The spleen is an oval area of dullness approximately _____ wide near the left tenth rib and slightly posterior to the MAL.
7 cm
Sharp pain occurs with inflammation of the kidney or paranephric area. (_____, _____, _____).
(Pyelonephritis, Renal calculi, Hydronephrosis)
_____ Inflammation of the kidney
_____ Kidney stones/ calcium buildup
_____ fluid buildup in the kidney
Pyelonephritis
Renal calculi
Hydronephrosis
✓_____ palpation = less than 1 cm depression to no depression.
✓_____ palpation: = 1 to 2 cm depression in circular motion
✓_____ palpation= With 2.5 to 5 cm depression to feel for deeper organs and structures.
✓_____ palpation= using two hands on each side of the body being palpated.
Light palpation
Moderate palpation
Deep palpation
Bimanual palpation
Ballotement Test
_____ Method – using a tapping or bouncing motion of the finger pads over the abdominal wall, feel for a floating mass.
_____ Method – place one hand under the flank (receiving/feeling hand) and push the anterior abdominal wall with the other hand.
Single-Hand Method
Bimanual Method
Hold your hand 90 degrees, or perpendicular, to the abdomen. Push down slowly then lift up quickly
Rebound Tenderness (Blumberg Sign)
Press deeply and evenly in the left lower quadrant. Drawing the force towards the ileocecal valve.
- Pain in the lower right belly when the left side is pressed and vise versa.
Rovsing’ Sign
With the person supine, lift the right leg straight up, flexing at the hip then push down over the lower part of the right thigh as the person tries to hold the leg up. When the test is negative, the person feels no change.
Iliopsoas Muscle Test
Flex the patient’s right thigh at the hip, with the knee bent, and rotate the leg internally at the hip. This maneuver stretches the internal obturator muscle.
- Pain in the lower belly when the hip is bent and the leg is turned inward.
Obturator Sign
Pain when pressing on the lower right belly (McBurney’s point).
McBurney Sign
Pain or the sudden stop of breathing when pressing under the right ribs while the patient inhales.
Test for gallbladder inflammation
Murphy’s Sign
A bluish or purple discoloration around the umbilicus that indicates INTRA-ABDOMINAL BLEEDING.
Cullen’s Sign
Palpable Spleen
Splenomegaly
_____ is the abnormal buildup of fluid in the abdomen, often due to liver disease.
Ascites
