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PE and DD > abdominal exam > Flashcards

abdominal exam Flashcards

1
Q

How many bowel sounds per minute is normal?

A
  • 5-35 per minute
  • (must listen at least 5 full minutes without hearing BS to document absent BS)
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2
Q

trace the flow of bile

A

Right and Left Hepatic ducts –>

common hepatic duct –>

joins cystic duct coming from gallbladder to form common bile duct –>

joined by pancreatic duct at ampulla of Vater (aka hepatopancreatic duct or ampulla) –> duodenal papilla

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3
Q

name the 9 abdominopelvic regions

A

right hypochondriac –> epigastric –> left hypochondriac

right lumbar –> umbilical –> left lumbar

right inguinal/iliac –> hypogastric (or suprapubic) –> left inguinal/iliac

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4
Q

What are possible causes of a protuberant abdomen? (the 7 F’s)

A
  • fat
  • feces
  • flatus
  • fluid/ascites
  • fetus
  • fibroid
  • freaking large/fatal tumor
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5
Q

describe McBurney’s point and McBurney’s sign

A
  • McBurney’s point is 1/3 the distance from the Anterior Superior Iliac Spine (ASIS) and the umbilicus
  • Positive McBurney’s sign= firm pressure over this point is held for a few seconds, then released quickly. If patient has pain (ie, rebound tenderness), indicates peritoneal irriation (such as from appendicitis)
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6
Q

Blumberg sign

A

rebound tenderness (pain is worse when pressure is released)

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7
Q

Cullen’s sign

A

peri-umbilical bluish discoloration

indicates intra-abdominal bleeding (eg, ruptured aoritc aneursym, pancreatitis, ruptured ectopic pregnancy, others)

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8
Q

What does high-pitched, tinkling bowel sounds suggest?

A

Intestinal fluid and air under pressure, as in early obstruction

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9
Q

List signs of peritonitis

A
  • limited abdominal movement with respiration, esp in males
  • Blumberg’s sign (rebound tenderness)
  • exquistely tender abdomen to palpation
  • nausea/vomiting
  • board-like abd rigidity (involuntary muscle guarding)
  • diminished/absent bowel sounds
    • obturator sign
    • iliopsoas sign
    • Markle sign
    • Ballance sign
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10
Q

describe liver and splenic friction rubs and what they might mean

A
  • high-pitched
  • associated with respiration
  • indicate inflammation of the peritoneal surface of the organ due to infection, infarction, or tumor
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11
Q

describe a venous hum and indication if heard in abdomen

A
  • soft
  • low-pitched
  • continuous
  • may occur with increased collateral circulation between portal and systemic venous systems
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12
Q

potential causes of pain in the right hypochondriac region

A
  • hepatitis
  • gallstones/biliary colic
  • right lower lobe pneumonia
  • hepatic rupture
  • gastric ulcers
  • pancreatitis
  • hepatic abscess
  • herpes zoster
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13
Q

potential causes of pain in the epigastric region

A
  • gastritis
  • gastric or duodenal ulcer
  • pancreatitis
  • hepatomegaly
  • hepatitis
  • hepatic rupture
  • myocardial ischemia/infarction
  • GERD
  • cholelithiasis- gallstones
  • AAA- abdominal aortic aneurysm
  • epigastric hernia
  • gastric cancer
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14
Q

potential causes of pain in the left hypochondriac region

A
  • splenic rupture/enlargement/infarction
  • pancreatitis
  • left lower lobe pneumonia
  • gastric ulcer
  • gastritis
  • perforated colon
  • aortic aneurysm
  • MI
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15
Q

potential causes of pain in the Right lumbar region

A
  • right pyelonephritis
  • constipation
  • urinary calculi
  • lumbar hernia
  • regional enteritis
  • small bowel obstruction
  • leaking aneurysm
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16
Q

potential causes of pain in the umbilical region

A
  • umbilical hernia
  • ruptured AAA
  • constipation
  • small bowel intestinal obstruction/ischemia
  • early appendicitis
  • diverticulitis
  • pancreatitis
  • mesenteric thrombosis
17
Q

potential causes of pain in the left lumbar region

A
  • left kidney pyelonephtritis
  • constipation
  • kidney calculi
  • perforated colon
  • strangulated hernia
  • leaking AAA
  • regional enteritis
  • diverticular disease
18
Q

potential causes of pain in the right inguinal/iliac region

A
  • Pelvic inflammatory disease
  • Right ovarian abscess/torsion/cyst
  • ectopic pregnancy
  • appendicitis
  • inguinal hernia
  • endometriosis
  • constipation
  • salapingitis
  • ureteral stone
  • meckel diverticulitis
  • perforated cecum
19
Q

potential causes of pain in the hypogastric (suprapubic) region

A
  • urinary tract infection
  • uterine cramps
  • uterine fibroids
  • pelvic inflammatory disease
  • pregnancy contractions, round ligament pain
  • diverticular disease
  • endometriosis
  • appendicitis
20
Q

potential causes of pain in the left inguinal/iliac region

A
  • left ovarian abscess, cyst, torsion
  • PID
  • left salpingitis
  • ectopic pregnancy
  • endometriosis
  • hernia
  • leaking aneurysm
  • diverticular disease

PE and DD (5 decks)

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