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PCM2 > Abdominal Exam 1 > Flashcards

Abdominal Exam 1 Flashcards

1
Q

Visceral Pain?

example?

A

Not localized –> goes to midline instead cause by distention, stretching or contracting of hollow organs, or organ ischemia. early appendicitis in periumbilical (nondescriptive), but late is localized.. it’s peritonitis

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2
Q

Parietal (somatic)

A

secondary to inflammation in the parietal peritoneum localized pain usually constant and more severe than visceral pain

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3
Q

`Referred Pain? examples of pancreatic pain?

A

originates in the abdomen but felt elsewhere.

pancreatic/duodenal pain –> back pain biliary tree –> right shoulder

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4
Q

What’s in the Right Upper Quadrant?

A

Liver, Gallbladder, Stomach, SI, LI

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5
Q

What’s in the Right Lower Quadrant?

A

Appendix, ovary, SI, LI

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6
Q

What’s in the Left Lower Quadrant?

A

Sigmoid Colon, Ovary, SI, LI

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7
Q

What’s in the Left Upper Quadrant

A

Spleen, Stomach, SB, LB

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8
Q

What’s in the epigastric area?

A

Pancreas, Liver, Gallbladder, Stomach, SI, LI

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9
Q
A

This is Striae (stress marks) –> history of having gastric surgery and losing weight.

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10
Q
A

Cullen’s Sign (echymosis around the belly button)

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11
Q

Normal bowel sounds, how many clicks/gurgles

A

5-34

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12
Q

How do you listen for abdominal bowel sounds? what about bruits?

A

Diaphragm

Bell

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13
Q

Absent bowel sounds is what?

Examples?

A

no sounds for more than 2 minutes

long lasting intestinal obstruction, mesenteric ischemia, intestinal perforation

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14
Q

Decreased bowel sound examples? What’s the difference between this and absent?

Increased bowel sounds examples?

A

Post surgical Ileus, peritonitis

Diarrhea, EARLY bowel obstruction

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15
Q

What sounds would suggest early intestinal obstruction?

What do bruits in abdominal auscultation suggest?

Friction rub?

Venous Hum?

A

High pitched

vascular sounds–> vascular obstruction

grating sounds –> inflammation of peritoneal surface of an organ

soft humming –> increased collateral circulation between portal/systemic system

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16
Q

Percussion assesses what?

what are the 4 types of sounds? what 2 are found in the abdominal?

which predominates

A

assessing for air or fluid

Percuss in all 4 quadrants

**tympany –> high pitch.. air filled

***Dull –> solid organs or masses

Resonance –> hollow abdominal organs (like the lungs)

hyperresonance –> air filled hollow organ (like a pneumothorax)

tympany

17
Q

How do we palpate the abdominal organs?

A

You gently palpate all 4 quadrants using the palmar aspect of your hand with fingers together

then do the same thing deeply again.

18
Q

What are you not going to feel during palpation, and if you do it’s not a good sign

A

spleen –> splenomegaly

19
Q

Liver increased span is associated with what?

decreased?

A

cirrhosis, heart failure, lymphoma, etc.

also cirrhosis (shrunken liver this time)

20
Q

Splenomegaly indicates what?

A

portal hypertension, blood malignancies, HIV, hematoma, Mono

21
Q

Ascites?

what test do you do for this and how does it work?

A

Fluid in the peritoneal cavity

“Shifting Dullness Test” –> percuss the borders of tympany and dullness with the patient and then have them lay on their side.

normal = borders stay the same

ascites/positive test = dullness shifts to dependent side and tympany to top side

(fluid and solid follow gravity so tympany shifts)!!

Also test for fluid wave –> can feel the wave on either side.

22
Q

McBurney’s Point?

Rovsing’s?

Psoas sign?

Obturator Sign?

A

all for appendicitis

McBurney’s –> line ASIS to umbilicus. –> 2 inches medial to ASIS on that line –> tenderness there = appendicitis

Rovsings –> palpate deeply in LLQ and you’ll get pain in the RLQ

Psoas –> ask pt to raise knee against resistance and then turn pt on their left side and extend right leg at the hip.. positive test is increased abdominal pain.

Obturator sign –> flex pt right hip with knee bent, internally rotate the hip –> right hypogastric pain = positive test

23
Q

Murphy’s sign?

A

Hands in right upper quadrant and push down and have them take a deep breath.

they’ll either stop breathing in or it’ll hurt a lot.

gallbladder pain!

24
Q

Pyelonephritis or ureterolithiasis.. what test do you do and where is it at?

A

at the costovertebral angle area –> Lloyd’s punch

25
Q

Rigidity of the abdomen?

Guarding?

Rebound Tenderness?

A

involuntary reflex contraction of the abdominal wall.. acute abdomen peritoneal inflammation… needs surgery

irritation of the peritoneum –> pushing in and their muscles are tensing up when you push in. (voluntary is them physically pushing you away.. involuntary is the muscles do it for you)

irritation of the peritoneum –> occurs when you push down and then let go quickly.. it hurts when you let go.

26
Q

VINDICATE mnemonic?

A

Vascular

Infectious/Inflammation

Neoplasm

Drugs/Degenerative

Iatrogenic/Idiopathic

Congenital

Autoimmune/Allergic/Anatomic

Trauma

Endocrine/Environment

27
Q

Cholelithiasis?

when do you get pain?

A

Gall stones.

when you eat fatty food, your gallbladder wants to release bile but it can’t, hence why there’s pain

28
Q

Pancreatitis is caused by what?

sometimes where does pain go?

what lab value would be super high?

A

heavy alcohol use and smoking

radiates to the back.

hurts in the epigastrium

Lipase

29
Q

what do we expect white counts to be for appendicitis

A

elevated.. sometimes a fever

30
Q

uretolithiathis where does it start

what kind of pain

radiation

urine?

A

flank or CVA

sudden pain

radiates sometimes to the genitalia

blood in urine

31
Q

What is the order of the physical exam for abdominals?

A

Inspection

Auscultation

Percussion

Palpation

32
Q

someone has a big spleen and a sore throat, what is it

A

Mono

33
Q

How do you diagnose for cholelithiasis?

A

ultrasound

PCM2 (10 decks)

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