Abdominal assessment Flashcards
What are you looking for in abdominal palpation?
Guarding
Rigidity
Tenderness
What are the 9 sections of the abdomen?
What kind of patients may have atypical presentation with abdominal assessment?
Elderly
Alcohol-dependent
Immunosuppressed
What can referred right shoulder pain signify?
Liver injury/damage
Perforated duodernal ulcer
What can referred left shoulder pain signify?
Pancreatitis
How does knee flexion reduce pain in peritonitis?
Reduces strain on the abdomen
What can (frank) red blood in vomit indicate?
Upper GI tear/lesions
What can mouth ulcers signify?
B12/Folate deficiency
Crohn’s disease
What is Crohn’s disease?
Long term inflammation of the bowel
What can steatorrhoea signify?
Higher fat content in faeces
Causes include:
Pancreatitis
Pancreatic cancer
Biliary obstruction
Coeliac disease
What the 6 Fs of abdominal distention?
Fat
Fluid
Flatus
Faeces
Foetus
Fulminant mass
What conditions most often cause ascites?
Liver cirrhosis
Cancers
What medications are not recommended for viral gastroenteritis?
Antibiotics, anti-diarrheal agents and anti-emetic
What can bloody or severe diarrhoea along with general gastroenteritis symptoms signify?
Bacterial infection, should be confirmed with a stool sample
What can severe lower abdominal pain with referred shoulder/neck pain signify in females?
Ectopic pregnancy
What can severe sudden onset peri-umbilical pain with migration to right lower quadrant signify?
Appendicitis
In suspected appendicitis what can sometimes cause a sudden reduction in pain?
Appendix rupture
How can a AAA affect the lower extremities?
Discolouration due to ischemia
What is the order of abdominal observations?
Inspect
Auscultate
Percuss
Palpate
What can white spots in the nails signify and what does this indicate?
Low albumin
Can indicate malnutrition, liver disease, kidney disease, or an inflammatory disease.
What can hyperactive bowel symptoms signify?
Diarrhoea, post-eating
What can hypoactive or absent bowel signs signify?
Ileus, constipation, peritonitis
What can abnormal bowel signs (e.g. tinkling) signify?
Bowel obstruction
How often should you hear bowel sounds?
Every 5-10 seconds
What is Blumberg’s sign and what can it signify?
Rebound tenderness, peritonitis
What is Rovsing’s and what can it signify?
Pain in the right illiac fossa with pressure on the left illiac fossa.
Appendicitis
What is the psoas sign and what can it signify?
Lower right quadrant pain with extension (or flexion against resistance) of the right hip.
Appendicitis, caused by the inflamed appendix coming into contact with the psoas muscle
What is the obturator sign and what can it signify?
Lower right quadrant pain with internal and external rotation of the flexed hip with flexed right knee
Appendicitis, caused by the inflamed appendix coming into contact with obturator internus muscle
What is Murphy’s sign and what can it signify?
Pain on deep inspiration when hand is placed below right costal margin along the mid clavicular line.
Cholecystitis
How do you test for ballot?
Left hand on patient’s back (flank area) under the 12th rib, pushing upwards
Right hand pushing down just below the anterior costal margin.
Ask the patient to take a deep breath to help descend the kidneys and ‘trap it’ between your two hands
What is ballot?
Kidney tenderness
