abdominal assessment - exam 2

Question 1

What should you ask the patient to do prior to abdominal assessment?

Answer 1

empty bladder

Question 2

Observation- Asymmetries:
the umbilicus should be ______

Answer 2

surface contour; any distention could be bowel obstruction, mass, etc.
swelling or ascites- possibility indicated by an inverted umbilicus
midline

Question 3

Discoloration -
Jaundice:
Eccymosis:
Vein detention:

Answer 3

jaundice w/ liver dysfunction, ecchymosis indicating bleeding, vein detention indicating liver or vena cava obstruction

Question 4

Markings such as

Answer 4

scars, rashes, stretch marks

Question 5

A pulsatile mass may indicate __________________ but is not unusual in lean individuals

Answer 5

abdominal aortic aneurysm

Question 6

A wavelike motion may indicate intestinal obstruction:

Answer 6

peristalsis

Question 7

What can indicate an hernia:

Answer 7

sudden bulging w lifting of the head or a cough indicate a hernia

Question 8

Auscultations should be performed before ___________ and ________ to avoid altering the bowel sounds

Answer 8

percussion and palpation

Question 9

Utilize stethoscope for ________mins. in each quadrant

Answer 9

2 min.

Question 10

Bowel Sounds:
—check each quadrant in a one spot T or F?

Answer 10

False- check in multiple spots

Question 11

What is a normal sound for the bowel?
—-abnormal? (2)

Answer 11

high-pitched clicks and gurgling every 5-10 secs.
non may indicate bowel obstruction, particularly w/cramping
more may indicate overactivity i.e., w/lactotse intolerance

Question 12

Abdominal Aorta- just ______ of midline and _______ at peri-sternal line
_________indicate turbulent blood flow

Answer 12

left; umbilicus
Bruits

Question 13

Percussions Procedure:

Answer 13

-hyperextend and apply firm pressure w/ the non-dominant and distal aspect of the middle finger
-Avoid contact w/ any other part of the head
-Position dominant hand close to surface w/ wrist extended
-Strike the non-dominant middle finger quickly and sharply w/ flexed dominant middle finger
-Strike twice

Question 14

What are normal sounds of percussions?

Answer 14

tympanic or hollow sound over stomach and bowels or more air-filled organs unless one is full of “substance”

Question 15

Deep________ or lasting _______ over thorax and lung
_______ sound over more solid or dull organs or even tumors
—-ex

Answer 15

resonance; sound
Dull; liver, heart, & diaphragm or spleen

Question 16

Location of the stomach to perform percussion?
Empty -sound? Full- Sound?

Answer 16

close to the lower left rib cage just inf. sternum
Emtypy- tympanic or hollow ; Full - dull

Question 17

Mid-clavicular percussion of liver location?
sounds: starts/changes to ….

Answer 17

just above the umbilicus, along the midclavicular line -progress superiorly
starts w/ tympany or hollow sound of bowel —> changes to dullness @ liver for 2.5 to 5 inches

Question 18

Abnormal sound of mid-clavicular percussion of the liver:

Answer 18

larger area of dullness

Question 19

Percussion of Spleen:
–Location
–Normal/ Abnormal sound

Answer 19

starts left lower rib cage anterior axillary line

Normal: tympany or hollowness should be produced; move posteriorly toward mid-axillary line —–> dull (present between 9th and 11th ribs)

Abnormal: dullness noted more medially and inferiorly, more dullness while inspiring.

Question 20

Kidney percussion (Murphy Test ) in sitting or prone with a firm

Answer 20

fist thumping on the contralateral flat hand over costovertebral angle looking for P!

Question 21

Kidney palpations you should start with:
-hand placement:
-be sure to look for _______ & _______
-Normal feel:

Answer 21

firm, light pressure in a slow circular fashion within each quadrant
broad hand contact, and possibly palpate through the patient’s hands
masses & mm. guarding
pressure

Question 22

Kidney palpations
Abnormal feel:
–confirm by doing:
–progress to:
–crepitus or crunchiness indicate ______

Answer 22

tenderness or muscle gauding may indicate swelling or dysfunction
confirm for a similar response with percussion or cough
progress to rebound tenderness if necessary by applying pressure then quickly release
excess air

Question 23

Hernia is common around the umbilicus and inguinal areas. T or F

Answer 23

True

Question 24

Notable areas of potential swelling during palpation:

Answer 24

Gastritis (stomach inflammation)
Diverticulitis (intestinal inflammation)
Appendicitis (appendix inflammation)
Hepatitis (liver inflammation)
Pancreatitis (pancreas inflammation)
Spleen

Question 25

Abdominal Aorta Artery:
—pt. position
—PT should utilize:
—find pulse just to the_________

Answer 25

hook lying
two index fingers
left of the umbilicus or left peri sternal line and masses up and down abdominal region

Question 26

what are the grades to assess strength of someone’s abdominal aortic artery?

Answer 26

0 = absent
2+ = normal
4+ = bounding

Question 27

You can assess the width of the abdominal aortic artery by
–normal width
—abnormal width –> confirm with?

Answer 27

slowly moving fingers apart
1 inch
≥ 3cm may indicate aneurysm; auscultation

Question 28

How do you perform neuro testing for the abdomen:

Answer 28

T7-T12 w/ light and sharp touch from xiphoid process to inguinal ligament

Question 29

Superficial abdominal reflex for UMN lesion is assessing _______ lesion
– test by:
–normal:

Answer 29

UMN
diagonally stroking from umbilicus to outer border of each quadrant
the umbilicus should move in the direction of the stroke