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Clinical Skills > Abdominal Exam > Flashcards

Abdominal Exam Flashcards

1
Q

What do you look for when inspecting from the end of the bed

A 
Body Habitus - Physique or body build
Scars
Jaundice
Abdominal distension - abnormally swollen outwards
Masses
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2
Q

What do you look for in the hands

A

Dorsal:
Koilonychia - spooned out soft nails
Leukonychia - white dots on nails (due to iron deficiency)

Palmar:
Erythema
Dupuytren’s contracture
(both due to liver disease)

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3
Q

What does asterixis indicate

A

Hepatic encephalopathy

Uraemia

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4
Q

What do you inspect the axillae for

A

Acanthosis Nigricans

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5
Q

What do you look for in the facial inspection

A

Eyes:
Xanthelasma (hyperlipidaemia)
Kayser-fleischer ring
(copper deposition due to Wilson’s disease)

Lower eyelid:
Conjunctival Pallor (Anaemia)

Upper eye:
Jaundice (Raised bilirubin)

Mouth:
Angular stomatitis (due to iron deficiency)
Oral Candidiasis - white tongue
Mouth ulcers
Glossitis
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6
Q

What are causes of lymphadenopathy

A

Infection

Malignancy

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7
Q

Where is virchow’s Lymph node

A

Left supraclavicular fossa

Associated with gastric malignancy

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8
Q

What do you look for during the chest inspection

A

Spider Naevi

Gynaecomastia

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9
Q

What are the 9 regions of the abdomen (upper left to bottom right)

A

R. Hypochondrium
Epigastrium
L. Hypochondrium

R. flank
Umbilical Region
L. flank

Right Iliac fossa
Suprapubic region
Left iliac fossa

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10
Q

What do you look for during inspection of the abdomen

A 
Scars (laparoscopy) and Striae
Masses (Hernia, kidney transplant)
Distension
Pulsations
Stomas - opening in the abdomen
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11
Q

What is abdominal guarding

A

Tensing of the abdominal walls to guard inflamed organs (upon pressure)

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12
Q

What does an expansile pulsating mass during aortic palpation indicate

A

Abdominal aortic aneurysm

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13
Q

What aortic pathology could you hear on auscultation

A

Bruit

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14
Q

What tests could you do to complete the exam

A

Examine Hernial orifices
Digital rectal exam
Examination of external genitalia if indicated

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15
Q

Where does the subcostal plane lie

A

Below the 10th rib (L3)

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16
Q

What is the transtubercular plane and where does it lie

A

Highest point of the pelvis seen from the front

Can use either the level of the iliac crest (slightly high) or the ASIS (slightly lower)

17
Q

Where is the umbilicus

A

L3/4 of the vertebral column

18
Q

Where is the transpyloric plane

A

L1 - half-way between the sternal notch and pubic symphysis/Xiphi and umbilicus

19
Q

What organs does the transpyloric plane cross

A 
fundus of the gallbladder
Pylorus
Neck of pancreas
Origins of SMA
Hepatic portal vein
Duodenum (1st or 4th part)
Kidneys - left hylum, right upper pole
20
Q

What are rare signs in the abdomen

A 
Visible peristalsis (v significant)
Caput medusae (portal hypertension due to liver cirrhosis)
Sister Mary Joseph's sign (metastasis in umbilicus)

2 signs of retroperitoneal bleeding:
Cullen’s sign (periumbilical bruising)
Grey turner’s (flank bruising)

21
Q

What are the clinical signs of appendicitis

A

McBurney’s point - 1/3 distance from ASIS to umbilicus

Rovsings sign - pressure in LIf causes pain in RIf

22
Q

What are the clinical signs of Cholecystitis

A

Murphey’s sign - Press gently beneath the R costal margin in the MCL and ask patient to breathe in. Ifthe gallbladder is inflamed the patient will feel a sharp pain

23
Q

What lies in the superior 3 regions of the abdomen

A

Right hypochondrium:
Liver, Gallbladder, Right Kidney, SI, Ascending colon, Transverse colon

Epigastric Region:
Stomach, Liver, Pancreas, SI, Spleen, Adrenal glands, Transverse colon

Left hypochondrium:
Stomach, Left kidney, Spleen, Pancreas, part of the SI, Transverse colon, Descending colon

24
Q

What lies in the middle 3 regions of the abdomen

A

Right Lumbar: Gallbladder, Tip of the liver, Right Colon, ascending colon, right kidney

Umbilical Region:
Umbilicus (navel), SI, Transverse Colon

Left Lumbar:
Descending Colon, Tip of the left kidney

25
Q

What lies in the inferior 3 regions of the abdomen

A

Right Iliac fossa:
Appendix, Caecum, ascending colon

Hypogastric Region:
Urinary Bladder, Sigmoid Colon, Rectum, female reproductive organs

Left Iliac fossa:
Descending Colon, Sigmoid Colon

Clinical Skills (14 decks)

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