Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IPES QUIZ WEEK 14 > Abdominal Evaluation > Flashcards

Abdominal Evaluation Flashcards

1
Q

Indications for Abdominal Exam

1-Abdominal Pain, acute and chronic
2-Trauma
3-Indigestion, heartburn, nausea or vomiting
4-Vomiting blood
5-Loss of appetite, early satiety
6-Dysphagia, ordynophagia
7-Bowel/bladder changes
8-Diarrhea, constipation
9-Dysuria, urgency, frequency
10--Urinary incontinence---ex----Males: hesitancy, decreased stream
11---Hematuria
12--Suprapubic pain
13--Excessive gas, abdominal fullness
14--Visceral Pain
15--Unexplained low back pain
16--Unexplained sacral, pelvic or thoracic pain
17--Kidney or flank pain
18--Menstrual irregularities
19--Jaundice
A

keep looking at this monster list!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Definitions of AB EVALUATIONS–1

1—–__________ - difficulty swallowing
2—-___________ - pain on swallowing

A

Dysphagia

Odynophagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Definitions of AB EVALUATIONS–2

3——-____________ - vomiting blood
EX. Red or coffee ground appearance
EX. Ulcers

A

Hematemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definitions of AB EVALUATIONS–3

Heartburn X 3

1–Retrosternal burning which may radiate to the neck
2—-______(DDX) = Increased with exertion, decreased with rest
3–_______ = Increases with meals

A

Angina

Reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definitions of AB EVALUATIONS–4

4—____________—– Bright red blood in stool = Indicates LOWER GI bleed

  1. ________——Digested or oxidized blood in the stool, tarry in color Indicates UPPER GI bleed
A

Hematochezia

Melena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Definitions of AB EVALUATIONS–5

  1. __________ = Fat in stool, grey or white
  2. __________ = Feeling of incomplete voiding of the bowel
A

Steatorrhea

Tenesmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

History–Patterns of Pain—1 OF 3

1—-VISCERAL PAIN = (Visceral: Referring to the viscera, the internal organs of the body, specifically those within the chest (as the heart or lungs) or abdomen (as the liver, pancreas or intestines).

a. –______ organ contracts too forcefully or becomes over distended or stretched
b. –______ organ cause pain when its capsule is stretched
i. e. liver distention from alcoholic hepatitis
c. —Gnawing, burning, cramping, aching

A

Hollow

Solid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

History–Patterns of Pain—2 OF 3

2—PARIETAL PAIN = The parietal peritoneum lining the abdominal cavity. Inflammation of parietal peritoneum

a. Steady, aching pain
b. MORE SEVERE than visceral pain
c. Aggravated by ______and coughing = Generally patient wants to lay still.

A

movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

History–Patterns of Pain-3 OF 3

3—Referred pain

a. Develops over initial site then refers as severity increases, usually well localized
b. Duodenal or pancreatic pain may refer to _____
c. Pain from biliary tract may refer to ______ shoulder or scapula
d. Pain from pleura or heart may refer to _______ region

A

back

right

epigastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PAIN OF ABDOMINALS IN GENERAL

1—Onset: acute or chronic
a. Abrupt (seconds to minutes) =________ or rupture
b. Slow onset = __________ or obstruction
2—Ask patient to describe pain, have patient point to pain
3–Positional or occurs only with movement?
4–Timing of meals
a. on a Empty stomach = Ulcer
b. on a Full stomach = Reflux or GERD and gastritis cause epigastric pain

A

Blockage

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

LOCATION of pain in ABS– See Table 11-11, pp. 467-8

1–Epigastric
a. Indigestion vs. angina referral
b. Angina precipitated by exertion, relieved by rest
2–_________:
a. Begins periumbilical then migrates to right lower quadrant
3–___________:
a. Left lower quadrant
4–Large bowel obstruction
a. Diffuse abdominal pain, guarding, absent bowel sounds

A

Appendicitis

Diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AB PROBLEMS 1 OF 3

1—Bloating and indigestion
2—Nausea/vomiting
a. Relief with vomiting—ex. Peptic ulcer
b. Severe–ex. Gall stones
c. Appearance of vomitus
ex. Coffee grounds – partially digested blood
ex. _________– vomited blood (red or digested)
3—_________ pain may lead to anorexia, nausea, vomiting and other GI disorders

A

Hematemesis

Abdominal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AB PROBLEMS 2 OF 3

  1. Changes in stool, bowel/bladder habits = Cancer, irritable bowel
  2. ________ = Irritable bowel, lactase deficiency, diet
  3. Diarrhea
    a. Acute (2 weeks or less), usually from infection
    b. Chronic (4 weeks or more), non-infectious.
    ex. Crohn’s, ulcerative colitis
    c. Mucus, pus, or blood:__________ condition
A

Flatulence

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AB PROBLEMS 3 OF 3

  1. Greasy, oily, frothy, foul-smelling
    a. ________ or fatty stools (float)
    b,. Celiac sprue, pancreatic insufficiency
  2. Secondary to ______
A

Steatorrhea

meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Constipation:

2 of the following in 12 weeks during the previous 6 months
EX. Fewer than 3 bowel movements per week
EX. Straining
EX. Incomplete evacuation
EX. Hard or lumpy stools
EX. Manual facilitation

1—Meds
2–Intestinal obstruction
EX. Obstipation: passage of no stool or gas
3—Melena (black, tarry stools):________ GI bleed
4—Hematochezia:_______ GI bleed
5—Blood on toilet paper: hemorrhoids

A

upper

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Appearance of Vomitus and Feces

1—-What does the vomit look like?

a. Food = ____________ obstruction
b. Smells like feces = ___________ obstruction

2— What does the fecal matter look like?

a. Inadequate filling = Secondary to fiber, fluids
b. Inadequate emptying = Secondary to medications or immunosuppression

A

Esophageal

Intestinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MORE AB PROBLEMS

1--Fatigue due to anemia
2---Associated with MENSES: 
a.  Missed period = Ectopic pregnancy 
b.  Pain after menses = PID 
c.  Pain between menses = \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_
d.  Cyclic pain  = Dysmenorrhea or Endometriosis 
3--Taking NSAID or other meds
4--Weight loss 
5--Urinary changes
A

Ovarian cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Urinary tract PROBLEMS X 10

  • -Difficulty
  • -Frequency
  • -Night time habits
  • -Pain or burning
  • -Volume
  • -Urgency
  • -Difficulty starting stream
  • -Low force
  • -Stop and start
  • -Dribbling
A

KNOW THIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Suprapubic pain

1—-Bladder

a. Infection –_____pain with pressure
b. Sudden retention/sudden over distention – pain is ________
c. Chronic distention – usually _________

A

dull

agonizing

painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dysuria is painful or uncomfortable urination, typically a sharp, burning sensation

1—-Painful urination or DYSURIA suggests _______
a. Urethritis
b. Vulvovaginitis
c. Consider bladder stones, tumors, prostatitis
2—Pain around perineum in males is prostatic

A

**DYSURIA—Urgency, Frequency (Table 11-6, pg. 461)

infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Polyuria or _________
Polyuria – increase in 24 hour output

(Polyuria is a condition usually defined as excessive or abnormally large production or passage of urine)

A

nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Urinary incontinence – not uncommon in elderly — the loss of bladder control — is a common and often embarrassing problem.

1–Stress incontinence
EX._______contractility of urethral sphincter (S2-S4)
2–Urge incontinence
EX. _________ of detrusor muscle
3–Overflow incontinence
EX. Bladder overfills before bladder pressure exceeds urethral pressure
4–Neurologic
EX. MS
5–Functional status
EX. Impaired cognition, musculoskeletal dysfunction, immobility

A

Decreased

Overactivity

23
Q

Hematuria— is_______in the urine
Gross hematuria
Occult hematuria

A

blood

24
Q

Kidney or flank pain

1–Kidney
EX. _______, fever, unable to find comfortable position
2–Renal and ureteral colic
EX. Sudden _______ of ureter

A

Chills

obstruction

25
Q

Jaundice

1—_______: yellowing of skin and sclera = Increased bilirubin from breakdown of hemoglobin
2—Gray stools from bilirubin being excreted into intestine
3—CAUSES OF JAUNDICE
–___________
–___________
–Toxic liver damage secondary to meds or environmental toxins
–Obstruction secondary to surgery
–Hereditary disorders

A

Icterus
*** Jaundice, also known as icterus, is a term used to describe a yellowish tinge to the skin and sclerae

Hepatitis

Cirrhosis

26
Q

Past and Family Medical History

1---\_\_\_\_\_\_\_\_\_
EX.  Colon
EX..Stomach
EX.  Other GI
2--GI disorders 
3--Liver, gall bladder, kidney, pancreas, spleen disorders
4--Abdominal surgeries 
5--Aneurysms
A

Cancer

27
Q

KNOW THE FOUR QUADRANTS!!

A

SLIDE 27

28
Q

KNOW YOUR “REGIONS”

A

SLIDE 28

29
Q

KNOW YOUR “TYPES OF VISCERAL PAIN LOCATIONS”

A

SLIDE 29

30
Q

Prior to AB exam

1—_________ __________
2—Patient supine and comfortable
EX. Pillow under head and knees
3—Arms at side or across chest
EX. Not above head to avoid stretching abdomen
4—Ask about __________ of pain
5—Warm hands and stethoscope and proceed slowly

A

Void bladder

locations

31
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–1

___________: Right inferior scapula

A

Gallbladder

32
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–2

________ Left shoulder blade

A

Lung:

33
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–3

__________: Epigastric referral

A

Stomach

34
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–4

________: Flank

A

Kidney

35
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–5

___________: Lower T/S and/or Right T/S

A

Pancreas

36
Q

Back pain due to visceral somatic referral—Back pain may be the earliest and only manifestation of visceral disease–6

_______: Left sided low back pain

A

Spleen

37
Q

AB Examination ORDER….MUST KEEP THIS LINE UP!!

1--Inspection 
2--Auscultation 
3--Percussion 
4--Palpation 
5--Provocative maneuvers
A

KNOW THIS SHIT!!

38
Q

Inspection—STEP ONE OF AB EVALUATION

1–Observation contour and movements
EX. Flat, rounded, bulging, scaphoid (concave), symmetrical Bulging flanks from ascites
2–Skin
EX. Scars, striae (stretch marks), dilated veins, rashes, lesions, bruising
3–________
EX. Fat, fluid, feces, fetus, flatus, fibroid, full bladder, tumor
4–Visible masses, herniations
5–Visible peristalsis
EX. Intestinal obstruction
6–Increased ___________
EX. Abdominal aortic aneurysm

A

Distention

pulsations

39
Q

Hernia

1—Tissue which protrudes through a ________ in the abdominal musculature

a. Congenital = Weakened structure
b. Secondary to ________ (lifting, obesity, pregnancy)

2—there are 4 Types

a. Epigastric
b. Umbilical
c. Femoral- usually ________
d. Inguinal (direct/indirect) usually ______

A

defect

trauma

women

men

40
Q

Diastasis Recti

1—Tear in the______ ______ which allows protrusion of the rectus abdominus muscle
2—Easily seen while patient does a sit up
3—Abdominal _________may be increased because there is NO tissue layer on top of the aorta
a. Rule out an aneurysm

A

linea alba

pulsation

41
Q

Auscultation OF AB AREA—1 of 2

1---Bowel sounds 
a.  Normal = 5-34/minute 
b.  Clicks and gurgles (\_\_\_\_\_\_\_\_\_\_\_\_)
2---Friction rub over liver or spleen
a.  Liver tumor, splenic infarction, gonococcal infection
3----\_\_\_\_\_\_\_\_\_\_\_ bowel sounds
a.  Paralytic ileus 
b.  Peritonitis 
4---\_\_\_\_\_\_\_\_\_\_\_ bowel sounds
a.  Gastroenteritis 
b.  Early obstruction 
c.  Hunger
A

borborygmi

Decreased

Increased

42
Q

Auscultation OF AB AREA– 2 of 2

  1. _______–a sound or murmur heard in auscultation, especially an abnormal one…ex. a “whooosh”

4 POPULAR LOCATIONS:

a. Aorta
b. Renal arteries
c. Iliac arteries
d. Femoral arteries

  1. Bruits with only a systolic component may be normal
    a. Does patient have history of HTN? (HIGH BLOOD PRESSURE)
    b. Heard systolic and diastolic suggests ________, possibly secondary to renal artery stenosis
A

Bruits

HTN

43
Q

Percussion OF ABS

1–Normal
a. ___________ (predominates) ex. Gas
b. Dullness (scattered throughout) ex. Solid or fluid
c. Tympany throughout suggests intestinal obstruction
2–Used to assess size and location of solid organ
3–Used to find abnormal mass
4—Dullness in both flanks indicates ________

A

Tympany

ascites

44
Q

Palpation

1—Palpate _______ _________ from pain first

2—-Light palpation—look for:

a. Tenderness
b. Muscle guarding
c. Superficial masses
d. Superficial organs
e. Pulses
f. Lymph nodes

3—Deep palpation–look for:

a. Deep organs
b. Deep masses

A

furthest away

45
Q

ORGANS LOCATIONS

LEFT
1--Spleen -\_\_\_\_\_TO\_\_\_\_RIB  mid-axillary line, Traube’s space 
2--Stomach 
3--Pancreas 
4--Kidney

RIGHT
1–Liver =________ rib & mid-clavicular line, soft & sharp edge, may be tender
2–Gall bladder
3–Kidney

A

9-11th rib

7-11th

46
Q

Provocative–1 OF 4

Gall bladder

1—Murphy’s sign

a. _____ ___________ (or acute inflammation)
b. Patient on back, palpate deeply under right, lower ribs, deep breath, sudden stop of inhalation/exhalation due to intense pain!!

A

Acute Cholecystitis

47
Q

Provocative–2 OF 4

Kidney

  1. Murphy’s punch
    a. Kidney _________, perinephritic abscess
    b. Tapping over back over region of kidney
A

infection

48
Q

Provocative–3 OF 4

Peritonitis— is an inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs

1—-Jar test
a. Lift and drop or strike heel
b. Do not use on ______ patients
2—-Rebound tenderness

A

trauma

49
Q

Provocative–4 OF 4

Appendix = 3 ways to test:

  1. _________ = Palpation of LLQ produces increased pain in RLQ
  2. Obturator sign = Irritation of obturator internus muscle
  3. Psoas sign–hold at 90 degrees and push leg down and have patient resist
A

Rovsing’s Sign

50
Q

OBTURATOR SIGN “DETAILS”

1—Pain on passive internal rotation of the flexed thigh. Examiner moves lower leg laterally while applying resistance to the lateral side of the knee (asterisk) resulting in internal rotation of the femur.

2—Anatomic basis for the obturator sign: inflamed appendix in the pelvis is in contact with the ______ _______muscle, which is stretched by this maneuver.

A

obturator internus

51
Q

Psoas Sign

1—Pain on passive extension of the right thigh. Patient lies on left side. Examiner extends patient’s right thigh while applying counter resistance to the right hip (asterisk).

2–Anatomic basis for the psoas sign: inflamed appendix is in a ______________ location in contact with the PSOAS muscle, which is stretched by this maneuver.

A

retroperitoneal

52
Q

Abdominal Vascular Conditions X 9

Aortic _________ (iliac, renal)

1–May or may not present with _______ ________
2–May or may not hear BRUIT
3–May or may not detect PULSATILE MASS
4–May mimic LOW back pain,
5–May have coldness or tingling in FEET
6–If CALCIFIC (atherosclerosis) may see on plain film x-ray.
7–Abdominal ________ is exam of choice to measure diameter/ CT if suspect bleed
8–Perform blood pressure, LE pulses, ask if history of smoking.
9–At __ cm it is surgical case!!

A

Aneurysm

abdominal pain

ultrasound

5

53
Q

Palpating for Abdominal Aortic Aneurysm–A.A.A.

1–Press firmly, deep into upper abdomen to identify pulsations
2–Should approximate 3 cm
3–If greater, refer for additional evaluation and imaging
4–DON’T FORGET _________

A

AUSCULTATION

IPES QUIZ WEEK 14 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions