Abdominal Flashcards
Focssed Abdo History (GI)
Gastrointestinal (GI):
- • Abdominal pain (acute/chronic)
- • Indigestion
- • Nausea/Vomiting
- • Decreased appetite
- • Difficulty swallowing (dysphagia)
- • Pain swallowing (odynophagia)
- • Fill up quickly (Early satiety)
- • Change in bowel function (+/-)
- • Diarrhoea/Constipation/incontinence
- • Jaundice
- • Blood in/around stools
- • Black sticky faeces (melaena)
Abdominal Regions
- R iliac (inguinal)
- R Lumbar
- R hypochondriac
- Epigastric
- L hypochondriac
- L lumbar
- L iliac (inguinal)
- Suprapubic (Hypogastric)
- Umbilical
Signs of Liver Disease
Jaundice Palmar erythema Duputyen’s contracture leukonychia Koilonychia Clubbing Liver flap Caput medusae Ascites Spider Naevi
Ascites test
Fluid wave Shifting dullness
Abdominal Assessment (Inspection)
- Eyes (Anaemia)
- Mouth (Moisture, colour, Sores)
- Skin (Jaundice)
- Hands
- palmar erythema
- duputyen’s contracture
- leukonychia
- koilonychia
- clubbing Liver flap
- Abdo
- pain
- masses,
- distension
- size
- shape
- symetry
- scarring
- abnormal movments
- caput medusae
- ascites
- spider naevi
Abdo pain
On movement on lying down sitting ability to cough
Overall Abdominal Assessment
Focussed Abdo History (GU & GI) Inspection Ausculatation (4 regions as bowel sounds travel + Arteries) Percussion (9 regions + Ascites test) Palpation (Light & Deep 9 regions + costovertebral tenderness)
Focussed Abdo History (GU)
Genitourinary (GU):
- • Lower back or lower abdo pain (flank/suprapubic)
- • Difficulty passing urine (dysuria)
- • Urgency/frequency of urination
- • Increased volume of urine (polyruria)
- • Need to go in the night (nocturia)
- • Blood in urine (haematuria)
- • Sexual history/concerns
- • STD history
- • Genital sores or discharge
Men:
- • Hesitancy/decreased stream
- • Testicular pain/masses
Women:
- • Obstetric history
- • Abnormal vaginal bleeding
- • ?pregnancy
- • Last period
Abdominal Assessment (Auscultation)
4 regions - Increased, decreased, absent (only > 5mins)
Bruits - Aorta, renal, & Iliac
Abdominal Assessment (Percussion)
9 regions:
- Tympany = gas
- Dullness = solid or fluid
- Normal = Would expect a mix
- If dull on sides and tympani in centre – would perform ascites test.
Ascites test:
- Fluid Wave test: Pt presses into centre of abdo. Feel on one side and gently flick contralateral side – will feel wave on contralateral side if fluid
- Shifting dullness: Central tymany, lateral dullness - Level of dullness shifts when patient turns onto side
Abdominal Assessment (Palpation)
Light palpation – to identify abdo tenderness, muscular resistance, suerfical organs and masses
Deep palpation - Identify any pain or masses noting:
Location, size, shape, consistency, tenderness, pulsation
Costovertebral tenderness - Renal tenderness
** rebound tenderness = peritoneal sign
