abdominal Flashcards
what is included in abdominal cavity
stomach small and large intestines liver gallbladder pancreas spleen kidneys bladder major vessels
women: uterus, fallopian tubes, ovaries
where does the esophagus lie
outside the abdominal cavity
vital pat of the gastrointestinal system
what is different in the order of assessment techniques
auscultate after inspection
why do you auscultate after inspection
alter bowel sounds or cause pain
what to note when inspecting
guarding or splinting inspect the umbilicus for: - postion - shape - color - discharge - masses
lesions
bruising, rashes, primary lesions
scars
location and length
silver striae or stretch marks
expected finding
dilated veins
unexpected finding
reflecting cirrhosis or inferior vena cava obstruction
jaundice, cyanosis, ascites
reflecting cirrhosis
concave
sunken apperance
convex
rounded
distended
large protrusion
flatus
protrusion is mainly midline, there is no change in flanks
hernias
protrusion through abdominal muscle wall are visible, especially when the client flexes the abdominal muscles
peristalisis
wavelike movements visible in thin adounts or in clients who have intestinal obstructions
pulsations
regular beats of movement midline above the umbilicus are expected findings in thin adults, but a pulsating mass is unexpected
what do bowl sounds result from
the movement of air and fluid in the intestines
when is the most appropriate time to auscultate bowl sounds
between meals
how many high pitch clicks and gurgles are there
5 to 35
how to determine absent bowl sounds
hear no sounds after listening for a full 5 min
loud growling sounds
hyperactive
what do hyperactive sounds indicate
gastrointestinal motility can cause:
- diarrhea
- anxiety
- bowl inflammation
- reaction to foods
percussion
- hear tympany over most of the abdomen
- lower pitch typany over the gastrc bubble in the left upper quadrant
- expect dullness over the liver or a distended bladder
- liver span is a measurement of liver size at the right midclavicular line
findings outside the normal range of percussion
hematomegaly
when palpating observe
facial grimaces- indicates tenderness
breathing slowly will
cause muscle relaxation
when pt. has abdominal pain palpate
over the area of pain last
light palpation
- use finger pads on one hand to palpate .5 in each quadrant
- expect softness, no nodules, no guarding
- bladder is only palpable if full
deep palpation
may be reserved for advanced or experienced practitioners
two hand approach
- top hand depresses the 1 to 3 in in depth
- bottom hand assess for organ enlargement or masses
- expected: stool can be palpable in descending colon
rebound tenderness (blumberg’s sign)
- indication or irritation or inflammation somewhere in the and cavity
- after releasing pressure, observe the clients response to see if releasing the pressure caused pain
what should you never palpate
abd mass, tender organs, or surgical incisions
expected changes with aging
- expected weaker abd muscles declining in tone, and more adipose tissue
- peritoneal inflammation is more difficult to detect due to less pain, guarding, fever, and rebound tenderness
- saliva, gastric secretions, and pancreatic enzymes decrease
- esophageal peristalsis and small- intestine motility decrease
