Abdominal Exam

Question 1

when hollow abdominal organs contract unusually forcefully or are distended or stretched.

Answer 1

visceral pain

Question 2

visceral pain

Answer 2

may be gnawing, burning, cramping, or aching

Question 3

epigastric pain

Answer 3

may be stomach, duodenum, or pancreas

Question 4

RUQ pain

Answer 4

may be liver or biliary tree

Question 5

Periumbilical pain

Answer 5

may be small intestine, appendix, or proximal colon

Question 6

Hypogastric pain

Answer 6

may be colon, bladder, or uterus

Question 7

Supropubic or sacral pain

Answer 7

from rectum

Question 8

timing of pain

Answer 8

acute or chronic? 15-30% of pt’s with nonspecific pain need surgery

Question 9

for pain

Answer 9

have pt point to location–severity 1-10

Question 10

aggravators or relievers

Answer 10

food, alcohol, medications, stress, body position, and use of antacids

Question 11

chronic or recurrent discomfort or pain centered in the upper abdomen

Answer 11

dyspepsia

Question 12

subjective negative feeling that is nonpainful

Answer 12

discomfort (bloating, nausea, upper abdominal fullness, and heartburn)

Question 13

3-month history of nonspecific upper abdominal discomfort or nausea not attributable to structural abnormalities or peptic ulcer disease

Answer 13

nonulcer/functional dyspepsia

Question 14

heartburn, acid reflux, or regurgitation more than once a week; likely

Answer 14

GERD

Question 15

GERD

Answer 15

gastroesophageal reflux disease

Question 16

angina may present as

Answer 16

heartburn

Question 17

pain with swallowing

Answer 17

odyophagia

Question 18

techniques for examining abdomen

Answer 18

IAPP–liver, spleen, kidneys, aorta

Question 19

Inspect

Answer 19

peristalsis
skin
umbilicus
contour of the abdomen
pulsation

Question 20

I peristalsis

Answer 20

observe several min if intestinal obstruction suspected

Question 21

I Skin– Note:

Answer 21

Scars–diagram location
Striae–stretch marks
Dilated veins
Rashes and lesions

Question 22

I Umbilicus

Answer 22

note contour and location–note any inflammation or bulges suggesting hernia

Question 23

I Contour of Ab

Answer 23

shape: flat, round, protuberant, scaphoind
Bulges
symmetrical
enlarged organs or masses

Question 24

I Pulsations

Answer 24

Aortic pulse often visible in epigastrium

Question 25

Auscultation of abdomen

Answer 25

bowel sounds | aorta

Question 26

A. Bowel Sounds

Answer 26

clicks and gurgles 5-34 per min

Question 27

unusual sound from blood passing by obstruction--heard when auscultating vessel

Answer 27

Bruit

Question 28

prolonged gurggels --stomach growling

Answer 28

borborygmi

Question 29

the state of perspiring profusely

Answer 29

diaphorosis

Question 30

A. bruits

Answer 30

over aorta, iliac arteries, and femoral arteries

Question 31

A. friction rubs

Answer 31

over liver and spleen

Question 32

Percussion of abdomen

Answer 32

helps to assess amount and distribution of gas in abdomen and ID possible solid or fluid-filled masses.

Question 33

Per. Abdomen

Answer 33

in all four quadrants lightly to assess distribution of tympany (predominate-- due to gas) and dullness (scattered from fluid and feces)

Question 34

a hollow drum-like sound created when gas filled area is struck sharply

Answer 34

tympany

Question 35

Per. lower anterior chest

Answer 35

btwn lungs above and costal margins below--find dullness of liver and splenic flexure of colon

Question 36

Light abdominal palpation

Answer 36

``` all quadrants superficial organs tenderness muscle tone "voluntary guarding" ```

Question 37

Abdomen inspection

Answer 37

5 S's ``` Size Shape Scars Skin lesions Stoma ```

Question 38

I'm A People Person

Answer 38

Inspection Auscultation Percussion Palpation

Question 39

Deep abdominal palpations

Answer 39

have pt cough and palpate area of pain (inflammation)

Question 40

pain induced or increased by quick withdrawal constitutes

Answer 40

rebound tenerness (press down with you fingers firmly)

Question 41

size of liver by

Answer 41

percussion--find borders of dullness--because behind ribs

Question 42

Liver percussion

Answer 42

R midclavicular line nipple down--upper border of dullness lower border of dullness

Question 43

method for palpating liver when patient is obese

Answer 43

Hooking technique--stand to R of pt's chest--place both hands side by side on right abdomen below border of liver dullness, press in w/ fingers and up toward costal margin.

Question 44

spleen percussion

Answer 44

dullness superiolateral to tympany of stomach--can be used to dx spleenomegaly