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PD Block 2 > abdominal > Flashcards

abdominal Flashcards

1
Q

RUQ

A
  • liver (right lobe)
  • gallbladder
  • duodenum
  • pancreas (head)
  • right kidney (upper pole)
  • right adrenal gland
  • hepatic flexure of colon
  • ascending colon (part)
  • transverse colon (part)
  • stomach (pylorus)
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2
Q

RLQ

A
  • right kidney (lower pole)
  • cecum
  • appendix
  • ascending colon (part)
  • right ovary
  • right fallopian tube
  • right ureter
  • right spermatic cord
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3
Q

LUQ

A
  • stomach
  • liver (left lobe)
  • spleen
  • pancreas (body)
  • left adrenal gland
  • left kidney (upper pole)
  • splenic flexure of colon
  • transverse colon (part)
  • descending colon (part)
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4
Q

LLQ

A
  • left kidney (lower pole)
  • descending colon (part)
  • sigmoid colon
  • left ovary
  • left fallopian tube
  • uterus, in enlarged (other side is in midline)
  • left ureter
  • left spermatic cord
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5
Q

9 abdominal regions

A
  • upper: right hypochondriac region, epigastric region, left hypochondriac region
  • middle: right lumbar region, umbilical region, left lumbar region
  • lower: right iliac (inguinal) region, hypogastric (pubic) region, left iliac (inguinal) region
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6
Q

components of abdominal exam

A
  • inspect
  • auscultate
  • percuss/palpate
  • most exams: inspect, palp, percuss, ascultate
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7
Q

visual inspection

A
  • skin color/surface changes
  • symm, shape, contour
  • deformities (masses, hernias, etc)
  • movement: pulsations in skinny people normal, perstalsis in most people not normal
  • striae
  • pigmentation (moles)
  • venous patterns
  • jaundice
  • umbilicus
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8
Q

striae

A
  • old: silver (ok)

- new: purple (cushings)

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9
Q

abdominal profiles

A
  • scaphoid (really skinny)
  • flat
  • rounded (kids, americans)
  • protuberant (distended)
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10
Q

auscultation

A
  • listen for presence of absence (if not there, listen for 5 mins)
  • diaphragm
  • light pressure in all 4 quads
  • frequency: 5-35 per min
  • character: high pitched, low pitched, gurgling, etc
  • borborygmi
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11
Q

borborygmi

A

rumbling, stomach growling

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12
Q

why do GU, rectal, pelvic exam with abdominal exam?

A

-in case of several symptoms (pain, bleeding, enlarging abdomen, etc) source of problem cannot be fully detected without examining these adjacent systems

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13
Q

referred pain in right upper quad

A

-pleuritic pain

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14
Q

referred pain in right lower quad

A

appendicitis

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15
Q

referred pain in periumbilical

A

appendicitis (transitions to RLQ pain)

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16
Q

referred pain in left upper quad

A

splenic infarct

17
Q

referred pain in left lower quad

A

diverticulitis

18
Q

referred pain in right shoulder

A

-acute cholecystitis

19
Q

referred pain in midsternal line

A

reflux

20
Q

referred pain in epigastric region

A

angina

21
Q

referred pain to back

A

acute pancreatitis

22
Q

cullen sign

A

Bluish color of/around umbilicus indicates intrapeflritoneal hemorrhage, pancreatitis, or ectopic pregnancy.

23
Q

ballottement

A

90 degrees from abdomen to move thing. Palpate and things move.

24
Q

grey turner sign

A

Eccymosis of flanks indicates hemoperitoneum or pancreatitis.

25
Q

shifting dullness

A

Determine border of tympany and dullness by percussion while suppine, mark this border. Have patient shift to their side and reassess. If ascites is present, the dullness will shift to the lowered side. 3cm or more difference from those marked borders indicates fluid is present.

26
Q

murphy sign

A

Abrupt cessation of inspiration while palpating gallbladder indicates cholecystitis.

27
Q

fluid wave

A

patient uses own hand as barrier in mid-abdomen. Tap on one side while palpating the other. Wave transmitted across is + for ascites.

28
Q

rovsing sign

A

RLQ pain intensified by LLQ abdominal palpation

29
Q

iliopsoas muscle test (psoas sign)

A

Painful RLQ suggests irritated peritoneal lining while flexing psoas muscle

30
Q

mcburney sign

A

Pain with palpation at McBurney point (RLQ midway between umbilicus and R anterior superior iliac spine) indicative of appendicitis or other peritoneal inflammation.

31
Q

obturator muscle test (obturator sign)

A

Testing for irritation due to obturator muscle. RLQ pain is + obturator sign.

32
Q

rebound tenderness (blumberg sign)

A

Pressing gently and deeply into abdomen in region remote to pain, when you take pressure off, the underlying structures rebounding back to their original positions causes pain and a positive rebound tenderness. Suggests peritoneal inflammation/irritation. (Do this last as it is painful for patient)

33
Q

heel jar test

A

Patient stands on tip toes then drops to heels (or patient is supine and strike their heels). If this causes abdominal pain = positive test for peritoneal inflammation.

34
Q

hematochezia

A

passage of fresh (bright red) blood within stool (bleeding in lower GI)

35
Q

melena

A

passage of dark tarry stools (indicates bleeding in upper GI)

36
Q

globus

A

the persistent or intermittent nonpainful sensation of a lump or foreign body in the throat; occurrence of the sensation between meals; absence of dysphagia and odynophagia

37
Q

singultus

A

hiccup (the state of having reflex spasms of the diaphragm

accompanied by a rapid closure of the glottis producing an audible sound)

38
Q

gastroparesis

A 
aka delayed gastric emptying= a medical condition consisting of 
a paresis (partial paralysis) of the stomach, resulting in food remaining in the stomach for an abnormally long time
39
Q

eructation

A

belch

PD Block 2 (5 decks)

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