Abdominal

Question 1

What are u looking for on the general contour of the abdomen?

Answer 1

Flat, scaphoid, distended, protuberant

Question 2

What other things are u looking for on inspection of the abdomen?

Answer 2

asymmetry, masses, lesions and scars

Question 3

What does caput medusa indicate?

Answer 3

heptic cirrosis, IVC obstruction

Question 4

Having the pt flex at the waist allows you to assess for what?

Answer 4

Hernias and rectus diathesis

Question 5

What should you do b4 u palpate the abdomen?

Answer 5

Auscultate

Question 6

What are normoactive bowel sounds?

Answer 6

Clicks and gurgles

Borborygmus: Rumbling of the large bowel

Question 7

What are the frequencies of bowel sounds?

Answer 7

Hypoactive
ileus )paralyzed bowel)
peritonitis (must auscultate for 2 minutes)
Normoactive: 5 to 34 per minute
Hyperactive: diarrhea, early obstruction

Question 8

What is borborygmi?

Answer 8

Absent with ileus

Increase with obstruction

Question 9

What is high-pitched tinkling?

Answer 9

Intestinal air and fluid under high pressure in a dilated bowel

Question 10

What are the 3 places u should auscultate for blood vessels?

Answer 10

aorta, renal arteries, iliac arteries

Question 11

What is a venous hum?

Answer 11

Rare
Systolic and diastolic
Indicates increased collateral circulation between portal and systemic venous systems
Hepatic cirrhosis

Question 12

What are friction rubs?

Answer 12

Rare
Grating which occurs with respirations
Indicate inflammation of peritoneal surfaces
Tumors, infection, abscess, splenic infarct

Question 13

What are the 3 types of resonance on percussion?

Answer 13

Dullness: increased with mass, organomegaly
Tympanic ordrumlike: gas in the digestive tract
Hyperresonant: obstruction

Question 14

What should u percuss for on the pt?

Answer 14

liver span and bladder height

Question 15

What is light palpation used for?

Answer 15

One hand using finger pads

Tenderness, masses

Question 16

What is deep palpation used for?

Answer 16

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

Question 17

3 signs of an acute abdomen?

Answer 17

Guarding
Rigidity
Rebound

Question 18

What is the ascites fluid wave test?

Answer 18

Patient is supine
Place lateral hands down the abdomen centrally (inhibits transmission through adipose)
Tap one side and feel for transmission in opposite hand

Question 19

What is the ascites shifting dullness test?

Answer 19

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

Question 20

What is Murphy’s sign?

Answer 20

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

Question 21

How do u test for Nephrolithiasis, Hydronephrosis, and Pyelonephritis?

Answer 21

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