Abdominal exam Flashcards
alimentary tract
27 ft long, mouth to anus
esophagus, stomach, small/large intestine
esophagus
posterior to trachea
descends through mediastinal cavity and diaphragm to stomach
stomach
lies transversely in upper abdominal cavity, below diaphragm
sections: fundus, body, pylorus
small intestine
21 ft long, 3 sections
dudoenum (c shape around the head of pancreas
jejumnum (shortest)
ileum
large intestine
ascending colon
transverse colon
descending colon
liver
RUQ, below diaphragm above gallbladder
- bile production
- excretion of bilirubin, cholesterol
- metabolism, fats, proteins, and carbohydrates
- storage of glycogen, vitamins and minerals
- synthesis of plasma proteins
pancreas
lies behind and beneath the stomach
acing cells produce digestive juices to break down protein/fats/ and carbs
also produces insulin
gallbladder
concentrates and stores bile from the liver
releases bile in response to cholecystokinin (duodenum)
bile serves to maintain the alkaline pH of the small intestine
spleen
LUQ, above L kidney and below diaphragm
made of white and red pulp
contains a reserve of monocytes
recycles old red blood cells, recycles iron
order of abdominal exam
inspect
auscultate (2nd to leave bowel sounds intact)
percuss/palpate
venous return pattern
above umbilicus: should be toward head
below umbilicus: should be toward feet
borborygmi
long prolonged gurgles indicating peristaltic activity
high pitched tinkles
cathedral sounds, suggestive of fluid air under pressure, bowel obstructions
why do rectal and pelvic exam while doing a abdominal exam
many possibilities in a differential diagnosis for abdominal pain ca be caused by problems in the genitourinary system.
cullen sign
bluish umbilicus indicates intraperitoneal hemorrhage
ballottement
palpation technique used to assess an organ or mass
grey turner sign
bruising between the last rib and the top of th hip, sign of retroperitoneal hemorrhage
shifting dullness
test for ascites, determine area of dullness while patient is supine and on their side
murphy’s sign
test for gallbladder irritation, similar to palpation for liver, have pt. inhale deeply, if pt. stops half way due to pain = + murphy
fluid wave
test for ascites: tap one side of abdomen, feel for wave on the other side with patients hand in the middle on the skin of stomach
rovsing sign
test for appendicitis, palpate LLQ, if causes pain in RLQ = + Rovsing
iliopsoas muscle test
pt. lift right leg against resistance or place patient on side and stretch psoas, either causes abdominal pain = + psoas sign
McBurney sign
test for appendicitis/ peritoneal inflammation
located RLQ, pain with palpation = +sign
Obturator muscle test
pt. supine, right leg raised and bent 90 degree, passively rotate leg in and out = pain = +sign
