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Clinical Med 44444 > abdominal exam > Flashcards

abdominal exam Flashcards

1
Q

organs in right upper quadrant

A
  • liver and gallbladder
  • Pylorus
  • duodenum
  • head of pancreas
  • right adrenal gland
  • portion of right kidney
  • hepatic flexure of colon
  • portions of ascending and transverse colon
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2
Q

Organs in Left upper quadrant

A 
Left lobe liver
Spleen
Stomach
Body Pancreas
Left adrenal gland & part of left kidney
Splenic flexure
Part of transverse & descending colon
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3
Q

Organs of Right Lower quadrant

A 
Lower pole of right kidney
Cecum & appendix
Bladder (if distended)
Ovary & salpinx
Uterus (if enlarged)
Right spermatic cord
Right ureter
Portion of ascending colon
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4
Q

Organs of Left Lower quadrant

A 
Lower pole Left kidney
Sigmoid colon
Bladder (if distended)
Ovary & salpinx
Uterus (if enlarged)
Left spermatic cord
Left ureter
Portion of descending colon
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5
Q

Define Grey-turners sign

A
  • Bruising of the Flanks
  • caused by Pancreatitis, abdominal trauma, ruptured AAA, ruptured ectopic pregnancy
  • Has a low specificity and disappointing sensitivity
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6
Q

Define Cullen’s sign

A
  • Periumbilical ecchymosis
  • suggests (hemoperitoneum
  • Caused by Pancreatitis, ruptured ectopic pregnancy
  • same low specificity and disappointing sensitivity as Grey turner
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7
Q

What is a localized bulge in the abdominal wall suggests

A

HERNIA

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8
Q

Patients with Peritonitis

A
  • have increased pain with sudden movements of the abdomen
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9
Q

Linea Nigra

A

a line of pigmentation that often develops during pregnancy

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10
Q

Caput Medusa

A
  • dilated tortuous, superficial veins radiating upwards from the umbilicus
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11
Q

Loud prolonged gurgles

A

borborygmi: normal sounds

- stomach growling

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12
Q

Increased sounds

A

gastroenteritis, early obstruction or hunger

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13
Q

High pitched tinkling

A
  • intestinal fluid and air under pressure

- early obstruction

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14
Q

Decreased sounds

A

Peritonitis and paralytic ileus

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15
Q

Abscent sounds

A

must listen for a full five minutes

- associated with pain and rigidity, surgical emergency

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16
Q

sign of interstinal obstruction

A

a protuberant abdomen that is diffusely tympanitic

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17
Q

The liver, spleen, kidney and aorta are palpable?

A

Liver - normal liver edge may be palpable
Kidney - normal kidney is not palpable
Spleen - if palpable it is considered enlarged
Aorta - may be palpable

18
Q

Define Peritonitis

A
  • inflammation of peritoneum

- typically made worse by patient movement, abdominal wall percussion, and with palpation

19
Q

Define tenderness

A

discomfort elicited by palpation

20
Q

Define Guarding

A
  • VOLUNTARY contraction of the abdominal musculature due to tenderness, fear, the examiners cold hands, or patients anxiety
21
Q

Define Rebound

A
  • abdominal tenderness that is WORSE when palpating fingers are quickly removed from the place of palpable tenderness
22
Q

Define Rigidity

A
  • INVOLUNTARY contraction of the abdominal musculature in response to peritoneal inflammation
    (involuntary guarding)
23
Q

Define McBurney’s point

A
  • 1/3 the distance along the imaginary line drawn from the anterior superior iliac spine to the umbilicus
  • represents the approximate position of the appendix in a non-pregnant adult
24
Q

Define Murphy’s sign

A
  • brief inspiratory arrest secondary to patient discomfort when the examiner presses their fingers inward in the RUQ mid-clavicular line
  • associated with ACUTE CHOLECYSTITIS
25
Q

Describe Pancreatitis

A
  • sudden LUQ, epigastric, or umbilical pain
  • may refer to left shoulder
  • associated: vomiting, fever, shock
    PHYSICAL EXAM = Epigastric tenderness, Positive Grey turner and Cullen signs
26
Q

Describe Cholecytitis

A
  • Severe, unrelenting RUQ or epigastric pain
  • refers to right subscapular area
  • associated symptoms: anorexia, vomiting, fever, possible jaundice
    PHYSICAL EXAM = RUQ tenderness, POSITIVE MURPHY SIGN
27
Q

describe DIVERTICULITIS

A
  • LLQ pain or localized to diseased area
  • Associated: fever, anorexia, diarrhea
    PHYSICAL EXAM: LLQ pain on palpation, borborygmus
28
Q

Describe pelvic inflammatory disease

A
  • Lower quadrant pain in sexually active females
  • Assocaited: nausea, vomiting, cervical discharge, dyspareunia
    PHYSICAL EXAM: adnexal and cervical tenderness
29
Q

Appendicitis

A
  • initially presents with periumbilical or epigastric pain that localizes to RLQ
  • associated: fever, nausea, vomiting, anorexia
    PHYSICAL EXAM: Guarding, Positive obturator, iliopsoas, rovsing, markle, McBurney’s sign
30
Q

Omphalitis

A
  • infection of umbilical area that may stay localized or extend into umbilical wall, fascia, and peritoneum and portal vessels
  • treatment = antistaphylococcal antibiotics
31
Q

what are the ways to keep a baby calm during palpation

A

Eating, sucking on pacifier, allow to stay on parents lap

32
Q

technique to palpation of a baby

A

flex infants legs at the hips and knees and wait for expiration to accomplish deep palpation
- Most common mass palpable in newborn is ENLARGED KIDNEY

33
Q

Describe auscultation and percussion in pediatric exam

A
  • different liver spans with differnent ages
  • infants = 1-3cm below costal margin
  • Hepatomegaly is when the liver is below this level and may be a sign of: congestive heart failure, infection, liver failure
34
Q

Toddler inspection

A
  • standing toddler has a lumbar lordosis which may give sense of abdominal distension
  • lay patient down to be certain
35
Q

umbilical cord

A

jelly consistency for a few days

- dries up and falls off by 14 days of age

36
Q

Blumberg sign

A

fixed dullness to percussion in left flank and dullness in right flank diasppears with position change
- INDICATES PERITONEAL IRRITATION OR APPENDICITIS

37
Q

Dance sign

A

absence of bowl sounds in RLQ

- INDICATES INTUSSUSCEPTION

38
Q

Kehr sign

A

Abdominal pain radiating to left shoulder

- INDICATES SPLEEN RUPTURE, RENAL CALCULI, OR ECTOPIC PREGNANCY

39
Q

MARKLE SIGN

A

hitting heels causing jarring of the body will cause pain

- INDICATES PERITONEAL IRRITATION OR APPENDICITIS

40
Q

MURPHY SIGN

A

ABRUPT CESSATION OF INHALATION WITH PALPATION OF GALLBLADDER

- INDICATES CHOLECYSTITIS

41
Q

Romber-howship sign

A

Pain medial aspec thigh to knee

- INDICATES STRANGULATED OBTURATOR HERNIA

42
Q

ROVSING SIGN

A

RLQ pain worsed by palpation of LLQ

- INDICATES PERITONEAL IRRITATION OR APPENDICITIES

Clinical Med 44444 (9 decks)

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