Abdominal Assessment

Question 1

bowel sounds

Answer 1

abdominal sounds caused by the products of digestion as they move through the lower gastrointestinal tract, usually heard on auscultation

Question 2

linea alba

Answer 2

tendinous seam that joins the 4 layers of large, flat muscles forming the ventral abdominal wall at the midline

Question 3

skin turgor

Answer 3

refers to the elasticity of the skin; its ability to change shape and return to normal and used to determine the extent of dehydration by pinching

Question 4

light palpation

Answer 4

detects surface characteristics and accustoms the person to being touched
- with the first four fingers close together, depress the skin approximately 1 cm and make a gentle rotary motion, sliding the fingers and skin together; then lift the fingers (do not drag them) and move clockwise to the next location around the abdomen (objective is to form an overall impression of the skin surface and superficial musculature)

Question 5

deep palpation

Answer 5

similar to light palpation but with pushing down 5-8 cm, assesses an organ or mass deeper in a body cavity

Question 6

rectus abdominus

Answer 6

forms a strip extending the length of the midline and its edge is often palpable; the muscles protect and hold the organs in place, and they flex the vertebral column

Question 7

bruits

Answer 7

vascular sound associated w/ turbulent blood flow

Question 8

dehydration

Answer 8

excessive loss of fluid in the body

Question 9

friction rub

Answer 9

rough, grating sound, like 2 pieces of leather rubbed together, indicating peritoneal inflammation (can occur over liver or spleen as a result of abscess, infection or tumour)

Question 10

what are the abdominal surface landmarks?

Answer 10

borders of the abdominal cavity, abdominal muscles and linea alba

Question 11

what are the 4 abdominal quadrants?

Answer 11

RUQ, LUQ, RLQ, LLQ

Question 12

what are the solid viscera of the abdomen?

Answer 12

liver, spleen, pancreas, adrenal glands, kidneys, ovaries, uterus

Question 13

what are the hollow viscera of the uterus?

Answer 13

stomach, gallbladder, small intestine, colon and bladder

Question 14

abdominal anatomy: developmental considerations for infants and children

Answer 14

prominence of umbilical cord containing 2 arteries and a vein, liver and urinary bladder position, abdominal wall less muscular, risk for GI illness and dehydration related to diarrhea and vomiting

Question 15

abdominal anatomy: developmental considerations for pregnant women

Answer 15

morning sickness, heartburn, constipation and decreased bowel sounds, hemorrhoids, intestines pushed upward and posteriorly

Question 16

abdominal anatomy: developmental considerations for older adults

Answer 16

suprapubic fat accumulation in women, abdominal accumulation in men, decreased salivation/gastric acid secretion, delayed esophageal emptying (risk of aspiration), more susceptible to dehydration, decreased liver size and increased gallstones, decreased renal function (adverse or toxic drugs effects), constipation, increased risk of colon cancer

Question 17

cultural and social consideration

Answer 17

increasing rates of obesity, prevalence of lactose intolerance, rates of celiac (autoimmune), GERD, peptic ulcer disease, inflammatory bowel disease (early age at onset for Crohn’s), relationship of hepA and GI illnesses to socioeconomic factors

Question 18

what should you ask for in the abdominal health history?

Answer 18

appetite, diet & nutritional assessment, dysphagia, food intolerance, abdominal pain, nausea/vomiting, bowel habits, past abdominal history, medications, alcohol and tobacco, impact on daily life

Question 19

preparations for the abdominal physical exam

Answer 19

lighting and draping, raise bed, measures to enhance abdominal wall relaxation (warm room, knees bent on pillow, arms at sides), equipment needed (stethoscope, alcohol swab)

Question 20

what is the order of abdominal assessment?

Answer 20

inspection, auscultation, percussion, palpation

Question 21

what do you inspect during an abdominal exam?

Answer 21

skin colour, moles, lesions, scarring, pulsation/movement, hair distribution, contour, symmetry, umbilicus, demeanor & facial expression

Question 22

what do you auscultate during an abdominal exam?

Answer 22

bowel sounds, vascular sounds (bruits)

Question 23

how to listen for bowel sounds

Answer 23

use the diaphragm, press lightly, start in RLQ and listen in all4 quadrants, zigzag across abdomen, note character and frequency (high pitched gurgling, irregular 5-30 times/min)

Question 24

why is auscultation done before percussion and palpation?

Answer 24

so bowel sounds are not altered by promoted peristalsis through palpation

Question 25

percussion in the abdominal assessment

Answer 25

percussion identifies abdominal contents, locates organs, screens for fluid and masses

• move clockwise
• general tympany

Question 26

what does palpation assess in the abdominal assessment?

Answer 26

texture, temperature, moisture, swelling, rigidity, pulsations, tenderness/pain, masses

Question 27

voluntary guarding

Answer 27

a deliberate muscle wall contraction; occurs when the person is cold, tense, or ticklish, is bilateral, and you will feel the muscles relax slightly during exhalation

Question 28

rebound pain

Answer 28

discomfort or tenderness that occurs with sudden release of pressure; a clinical sign of appendicitis

Question 29

if you identify a mass, note:

Answer 29

location, size, shape, consistency, surface, mobility, pulsatility, tenderness

Question 30

abdominal assessment: developmental considerations for infants and children

Answer 30

newborns: inspect umbilical cord, umbilical hernia, diastasis recti, movemment w/ respirations, differences in percussion and palpation, meconium

Question 31

abdominal assessment: developmental considerations for children

Answer 31

protuberant abdomen, positioning for palpation, use objective signs to aid assessment

Question 32

abdominal assessment: developmental considerations for older adults

Answer 32

increased fat deposits on abdomen and hips, thinner abdominal musculature, organs easier to palpate

Question 33

referred liver pain

Answer 33

RUQ or epigastrium

Question 34

referred esophageal pain

Answer 34

midepigastrium or lower sternum

Question 35

referred gallbladder pain

Answer 35

Right or left scapula

Question 36

referred pancreatic pain

Answer 36

midepigastric, radiating to back

Question 37

referred stomach pain

Answer 37

epigastric, radiates to back or substernal

Question 38

referred appendix pain

Answer 38

periumbilical, shifts to RUQ

Question 39

referred kidney pain

Answer 39

Flanks or lower abdominal

Question 40

referred small intestine pain

Answer 40

diffuse abdominal

Question 41

referred colon pain

Answer 41

lower abdomen