Abdominal Assessment Flashcards
Chronological order of abdominal assessment
1.
2.
3.
4.
5.
6.
preparation and positioning
observation
auscultation
percussion
palpation
neurological testing
With preparation and positioning:
Ask patient to _______ ________ prior to assessment
Position in ______ with _____s to side
Clinician stands on patient’s _____ side and in position to observe ______ reactions
empty bladder
supine
UE
right
facial
Observation:
Asymmetries
- Surface contour; any _____ could be bowel ______, _____ etc.
- ________ or ascites- possibly indicated by inverted ________
- Umbilicus should be in _______
distention
obstruction
mass
swelling
umbilicus
midline
Observation:
________ i.e., jaundice with liver dysfunction, ecchymosis indicating bleeding, vein distention indicating liver or vena cava obstruction
discoloration
Observation:
______- i.e., scars, rashes, stretch marks
markings
Observation:
Pulsatile mass may indicate _______ _______ ______ but not unusual on lean individuals
__________- a wavelike motion may indicate intestinal obstruction
Sudden bulging with lifting of the head or a cough could indicate a ________
abdominal aortic aneurysm
peristalsis
hernia
Auscultations:
Perform before ______ and ______ to avoid altering bowels
Utilize stethoscope for _____ minutes in each quadrant
percussion; palpation
2
Auscultations:
Bowel sounds
* check each quadrant in a couple of spots
_______- high pitched clicks and gurgling every 5-10 secs.
_______- None may indicate bowel obstruction, particularly with ______
- More may indicate _________ (ex. lactose intolerance)
Normal
Abnormal
cramping
hyperactivity
Auscultations:
_______ _______- Just to left of midline and umbilicus at peri-sternal line
______ sound indicates a turbulent blood flow
abdominal aorta
bruit
Percussions:
Procedure
_______ and apply _____ pressure with ____-_____ hand and distal aspect of the _____ finger
Avoid ______ with any other part of the hand
Position dominant hand close to surface with _____ _______
Strike the ____-______ middle finger quickly and sharply with the _____ dominant middle finger
Strike ______
Hyperextend
firm
non-dominant
middle
contact
wrist extended
non-dominant
flexed
twice
Percussions:
Normal sounds
________ or ______ sounds over stomach and bowels more air-filled organs unless one is full of “substance”
Deep _____ or lasting sound over _____ and ______
_______ over more solid or full organs or even tumors (ex. liver, heart, diaphragm, or spleen)
Tympanic; hollow
resonance; thorax; lung
Dullness
Percussion of the stomach:
Close to lower ______ rib cage just inferior to ________
______ or ______ sound if empty, otherwise dull if _____
left; sternum
tympanic; hollow; full
Mid-Clavicular percussion of the liver
Just above _______, along right ___-_____ line
Progress _________
Starts with _____ or ______ sound of bowel
Changes to ______ at liver for ____ to ______ inches
_________ of lung tissue begins superior to liver
Abnormal - larger area of ____________
umbilicus
mid-clavicular
superiorly
tympanic; hollow
dullness 2.5; 5
resonance
dullness
Anterior axillary line percussion of spleen
Starts at left lower _____ ______ anterior axillary line
______ or ______ sound should be produced
Move ______ toward mid-axillary line, should become _____
Dullness should be present between _____ and _____ ribs
rib cage
tympany or hollow
posteriorly
9th ; 11th
Anterior axillary line percussion of spleen
Abnormal:
Dullness noted more ______ and inferiorly
More dullness with ________
medially
inspiring
Kidney Percussion- Murphy Test
Kidney percussion in sitting or prone with ____ fist thumping on __________ flat hand over __________ angle looking for pain
firm
contralateral
costovertebral
Palpations:
Start with ____, _____ pressure in a circular fashion with each quadrant
______ hand contact and possibly palpate through patient’s hand
_______ in same plane as abdomen
If no resistance or symptom provocation, apply _______ pressure
Also look for _____ and muscle ______
_________: pressure
firm; light
broad
forearm
deeper
masses; guarding
Normal
Palapations:
Abnormal
If tenderness or m. guarding, it may indicated _____ or ______
Confirm for similar response with ______ or _______
Progress to rebound _______, if neccesary by applying pressure, then quickly ______
_______ or crunchiness indicates excess air
swelling; dysfunction
percussion; cough
tenderness
release
Crepitis
Palpations:
Abnormal
Hernias common around _________ and _______ areas; larger with trunk _____ activity (ex. crunch, cough)
______ or _______ may also be palpated
umbilical; inguinal; flexor
mass; cyst
Palpations:
________ - (stomach inflammation)- over epigastric area, just inferior to sternum
Gastritis
Palpations:
_______- (intestinal inflammation)- left lower quadrant
Diverticulitis
Palaptions:
________- (appendix inflammation)- right lower quadrant between ASIS and umbilicus
Appendicitis
Palpations:
Hepatitis is _______ inflammation
_______ upper quadrant; ask the patient to ______ and slowly move ______ during inhalation
Inferior border is _______
liver
right; exhale; deeper
palpable
Palpations:
_________ - (pancreas inflammation)- mid-clavicular line in right upper quadrant with max exhalation, press and hold deeper pressure while patient is inhaling
Pancreatitis
_______ is located at the ______ lower rib cage at anterior axillary line, ask patient to exhale and slowly more deeper during inhalation under rib cage
* not _______ unless pathological
Spleen
Left
palpable
Palpations:
Abdominal aortic artery
- Position:
Utilize two _____ fingers - Find pulse just to the _____ of the umbilicus or per-sternal line and assess ___ and _____ abdominal region
index
left
up; down
Palpations:
Abdominal aortic artery
Assess:
Strength
0 = ______
2+ = _______
4+ = ________
_______ by slowly moving fingers apart
Normal width: ___ inch (____ cm)
Abnormal: ≥ __ cm may indicate aneurysm thern confirm with auscultation
- provoke back pain
absent
normal
bounding
width
1
2.54
3
Neurological testing:
___-_____ dermatomes with light and sharp touch from _____ process to _____ ligament
T7-12
xiphoid
inguinal
Neurological testing:
______ abdominal reflex for _____ lesion
- Diagnostically stroke from umbilicus to ____ border of each quadrant
- Umbilicus should move in direction of the _______
Superficial
UMN
outer
stroke
