Abdominal Exam

Question 1

identify where the pain comes from

Answer 1

Question 2

location esophageal pain

Answer 2

usu retrosternal, xiphisternal, epigastric

Question 3

gastric pain location

Answer 3

typically epigastric

or in LUQ

Question 4

location gallbladder pain

Answer 4

classically in RUQ

(15% time in epigastric or LUQ)

Question 5

location small bowel pain

Answer 5

often referred to periumblical area

Question 6

location ileal pain

Answer 6

often in RLQ

Question 7

colonic pain

Answer 7

usu referred to LLQ and RLQ

Question 8

pancreatic pain

Answer 8

usu epigastric or periumblical in location or in LUQ

often radiating to the back

Question 9

location renal colic pain

Answer 9

often felt in back and loin and radiates to groin

Question 10

splenic pain location

Answer 10

LUQ

Question 11

hepatic pain location

Answer 11

RUQ

Question 12

dysphagia

Answer 12

difficulty swallowing

Question 13

odynophagia

Answer 13

difficulty swallowing that is painful

Question 14

hematemesis

Answer 14

blood in vomit

Question 15

hematochezia

Answer 15

passage of bright red blood in the stool

Question 16

melena

Answer 16

passage of very dark stool (often tarry), reflects conversion of Hgb to various breakdown products

Question 17

major causes of hematochezia

Answer 17

• hemorrhoids
• colorectal carcinoma
• colonic polyps

chronic diverticular disease

• inflammatory bowel disease
• angiodysplasia of the colon

acute infectious enteritis

infectious proctitis

• ischemic colitis

Question 18

RUQ contains

Answer 18

liver, gall bladder, (stomach?, pancreas?), kidney, hepatic flexure of the colon

Question 19

LUQ contains

Answer 19

pancreas, spleen, splenic flexure of colon

Question 20

RLQ contains

Answer 20

appendix, ileum, cecuum and right colon, ovary

Question 21

LLQ contains

Answer 21

sigmoid and left colon, ovary

Question 22

areas of abdomen

Answer 22

• epigastrium
• peri-umbilical
• suprapubic
• flanks

Question 23

epigastrium

Answer 23

stomach, gall bladder, pancreas

Question 24

peri-umbilical

Answer 24

small intestines, abdominal wall hernia

Question 25

suprapubic

Answer 25

bladder, uterus, ovary, colon

Question 26

flanks

Answer 26

kidneys, retroperitoneal colon (rt and lft), lymph nodes

Question 27

radiation of pain to right shoulder

Answer 27

organs under right diaphragm (gall bladder or liver)

Question 28

radiation of pain to left shoulder

Answer 28

organs under left diaphragm (spleen or splenic flexure distenction)

Question 29

radiation of pain to mid-back

Answer 29

stomach,esophagus, pancreas

Question 30

radiation of pain to groin

Answer 30

kidney, hip, hernia

Question 31

radiation of pain to testicle

Answer 31

kidney, prostate, inguinal hernia

Question 32

radiation of pain to anterior thigh

Answer 32

pelvic disease, psoas abscess or tumor, colonic disease

Question 33

crampy, colicky intermittment quality

Answer 33

consistent with obstruction (biliary, intestinal, renal)

Question 34

burning in epigastrium may suggest

Answer 34

acid irritation of stomach or duodenum

Question 35

pressure may suggest

Answer 35

distention, mass, or abcess

Question 36

inspection

Answer 36

don’t rush to touch

inspect shape, skin, bulges, peristalsis