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PCM2 Midterm > Abdominal Exam 1 > Flashcards

Abdominal Exam 1 Flashcards

1
Q

Visceral Pain

A

secondary to distention, stretching or contracting of hollow organ,
**Not localized

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2
Q

Parietal(Somatic) Pain

A

secondary to inflammation in the parietal peritoneum
usually constant and more severe than visceral pain
***localized
aggravated by movement or coughing
alleviated by remaining still

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3
Q

Referred Pain

A

originated within the abdomen is felt at distant sites that are innervated at approximately the same spinal levels as disordered structure

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4
Q

General ROS

A

fever, chills, chest pain, shortness of breath, cough

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5
Q

Focused ROS

A

GI: nausea, vomiting, diarrhea, black stools, blood in the stool, blood in the vomit
GU: dysuria, polyuria, hematuria, flank or CVA pain
GYN: vaginal bleeding, vaginal discharge, LMP, possible pregnancy

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6
Q

Past Surgical History

A

General
Complaint Specific
–abdominal (cholescystectomy, appendectomy)
–gynecologic (hysterectomy, BTL, C-Section, Ovarian cyst)

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7
Q

Medications

A 
GI prescriptions
OTC meds
-blood thinners
-NSAIDS
-Narcotics
-Steroids
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8
Q

Important GI Social History

A

Smoking, Alcohol, Drugs, Stress, Travel

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9
Q

GI Physical Exam

A
  1. Inspection
  2. Auscultation
  3. Percussion
  4. Palpation
    - -drape your patient
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10
Q

RUQ

A

liver, gallbladder, stomach, SB, LB

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11
Q

RLQ

A

Appendix, ovary, SB, LB

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12
Q

LLQ

A

sigmoid colon, ovary, SB, LB

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13
Q

LUQ

A

spleen, stomach, SB, LB

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14
Q

Epigastric Area

A

pancreas, liver, gallbladder, stomach, SB, LB

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15
Q

Auscultation

A

gives information about bowel motility
–bell used to listen to bruits

  • absent bowel sounds
  • decreased bowel sounds
  • increased bowel sounds
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16
Q

Absent Bowel Sounds

A

none for more than 2 minutes

d/t long lasting intestinal obstruction, intestinal perforation, mesenteric ischemia

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17
Q

Decreased bowel sounds

A

none for 1 minute

d/t post surgical ileus and peritonitis

18
Q

Increased Bowel sounds

A

diarrhea, early bowel obstruction

19
Q

High Pitched Bowel Sounds

A

sounds like tinkling

suggests early intestinal obstruction

20
Q

Bruits

A

vascular sounds resembling a hear murmur

-vascular obstruction

21
Q

Friction Rub

A

grating sounds with respiratory variation
inflammation of the peritoneal surface of an organ
listen over liver and spleen

22
Q

Venous Hum

A

increased collateral circulation between portal and systemic venous system
—epigastric and umbilical regions

23
Q

Percussion

A

Tympany predominates

protuberant abdomen tympanitic throughout may indicate an obstruction

24
Q

Palpation

A

gently palpate in all 4 quadrants
then deeply palpate in all 4 quadrants
**always start away from the tender area

25
Q

splenomegaly

A

when spleen enlarges, it expands anteriorly, downward and medially
–assess with percussion and palpation
dullness at midaxillary line

–portal hypertension, blood malignancies, HIV, splenic infarct, hematoma, mononucleosis

26
Q

Liver Percussion

A

start in RLQ and RUQ in mid clavicular line and palpate toward the dullness to hit the border of the liver

27
Q

Normal liver span

A

6-12 cm

28
Q

Liver Span

A

enlarged: cirrhosis, lymphoma, right sided heart failure, hemachromatosis
decreased: cirrhosis

29
Q

Irregular edge/nodules of liver

A

hepatocelluar carcinoma

30
Q

Firmness/hardness

A

cirrhosis, hemachromatosis, amyloidosis, lymphoma

31
Q

Shifting Dullness Test

A

percuss the borders of tympany and have the patients lay on side and percuss the borders again
normal: borders stay the same
positive test: ascites–dullness shifts to the dependent side and tympany to the topside

32
Q

Test for fluid wave

A

have patient rest hands over chest
ulnar aspects of hands midline and tap sharply on finger tips

normal: no impulse felt on the other flank
positive test: ascites–impulse transmitted to the other flank

33
Q

McBurneys Point of Tenderness

A

draw an imaginary line from ASIS to umbilicus and palpate 2 inches medial
positive test: tenderness

*Appendicitis

34
Q

Rovsing’s Sign

A

palpate deeply in LLQ quickly remove
positive test: pain felt in RLQ

*Appendicitis

35
Q

Psoas Sign

A

place hand above patients right knee and ask patient to raise thigh agains resistance
positive test: increased abdominal pain
*appendicitis

36
Q

Obturator Sign

A

flex patient right hip with knee bent then internally rotate the hip

positive test: right hypogastric pain

  • appendicitis
37
Q

Murphy’s Sign

A

Test for biliary colic
-with right hand, palpate deeply under right costal margin and ask patient to take a deep breath in and palpate deeper
+ test: sharp increase in tenderness with sudden stop in inspiratory effort

38
Q

Lloyd’s Punch

A

pain to deep percussion in CVA
+ test: pain implies kidney pathology
(pylonephritis, ureterolithiasis)

39
Q

Signs of Acute Abdomen

A

Guarding
Rigidity
Rebound tenderness

40
Q

Guarding

A

Voluntary contraction of the abdominal wall

when palpating the abdomen

41
Q

DDX

A

cholelithiasis, cholecystitis, pancreatitis, gastritis, PUD, UTI, hepatitis,

PCM2 Midterm (8 decks)

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