Abdominal Flashcards
What are u looking for on the general contour of the abdomen?
Flat, scaphoid, distended, protuberant
What other things are u looking for on inspection of the abdomen?
asymmetry, masses, lesions and scars
What does caput medusa indicate?
heptic cirrosis, IVC obstruction
Having the pt flex at the waist allows you to assess for what?
Hernias and rectus diathesis
What should you do b4 u palpate the abdomen?
Auscultate
What are normoactive bowel sounds?
Clicks and gurgles
Borborygmus: Rumbling of the large bowel
What are the frequencies of bowel sounds?
Hypoactive ileus )paralyzed bowel) peritonitis (must auscultate for 2 minutes) Normoactive: 5 to 34 per minute Hyperactive: diarrhea, early obstruction
What is borborygmi?
Absent with ileus
Increase with obstruction
What is high-pitched tinkling?
Intestinal air and fluid under high pressure in a dilated bowel
What are the 3 places u should auscultate for blood vessels?
aorta, renal arteries, iliac arteries
What is a venous hum?
Rare
Systolic and diastolic
Indicates increased collateral circulation between portal and systemic venous systems
Hepatic cirrhosis
What are friction rubs?
Rare
Grating which occurs with respirations
Indicate inflammation of peritoneal surfaces
Tumors, infection, abscess, splenic infarct
What are the 3 types of resonance on percussion?
Dullness: increased with mass, organomegaly
Tympanic ordrumlike: gas in the digestive tract
Hyperresonant: obstruction
What should u percuss for on the pt?
liver span and bladder height
What is light palpation used for?
One hand using finger pads
Tenderness, masses
What is deep palpation used for?
Tenderness Masses Hepatomegaly/masses Begin in the RLQ and work cephalad to the right costal margin Use rolling hand technique Kidney Uterine height Bladder distension Size of the aorta
3 signs of an acute abdomen?
Guarding
Rigidity
Rebound
What is the ascites fluid wave test?
Patient is supine
Place lateral hands down the abdomen centrally (inhibits transmission through adipose)
Tap one side and feel for transmission in opposite hand
What is the ascites shifting dullness test?
With patient on back intestinal gas rises toward umbilicus and that area is tympanic
With patient on their side the gas rises tot he lateral area and umbilicus is dull to percussion
What is Murphy’s sign?
Push up under the right costal margin until just beginning to cause pain
DO NOT MOVE YOUR HAND
Have patient take in a deep breath
Positive sign = patient suddenly halting the deep breath as the inflamed gallbladder touches the fingers
How do u test for Nephrolithiasis, Hydronephrosis, and Pyelonephritis?
CVA tenderness (Lloyd’s Punch)
Palpate the area first May illicit tenderness Place hand over the costovertebral angle Strike hand, not the patient Pain suggests inflammation
