Abdominal Exam Flashcards
1
Q
- Types of abdominal pain
A
- Visceral
- From stim of visceral pain fibers
- Secondary to distension, stretching or contracting of hollow organs, stretching capsule of organs or organ ischemia
- NOT LOCALIZED
- Parietal
- From stim of somatic pain fibers
- Secondary to inflammation in parietal peritoneum
- Localized
- Referred
- Originates within abdomen but felt at distant sites which are innervated at approximately same spinal levels as disordered structure
2
Q
- Focused ROS is based on _
- General ROS is performed _
A
- CC
- All the time
3
Q
- When asking about past surgical history, what surgical procedures should you be asking about?
A
- Abdominal
- Cholecystectomy
- Appendectomy
- Gynecologic
- Hysterectomy
- BTL
- C Section
- Ovarian Cyst
- Etc
4
Q
- What type of GI prescriptions may a patient be taking?
A
- H2 Blockers
- PPI
- Dicyclomine
5
Q
- What steps do you perform an abdominal exam?
- What else must you always do
A
- Inspection
- Ascultation
- Percussion
- Palpation
Drape the patient
6
Q
- What are the landmarks of the abdomen to look for during inspection?
A
- Xiphoid process of sternum
- Costal margin
- Umbilicus
- ASIS
7
Q
- What organs are located in which abdominal quadrants?
A
- RUQ
- Liver
- Gallbladder
- Stomach
- SB
- LB
- RLQ
- Appendix
- Ovary
- SB
- LB
- LUQ
- Spleen
- Stomach
- SB
- LB
- LLQ
- Sigmoid colon
- Ovary
- SB
- LB
- Epigastric area
- Pancreas
- Liver
- Gallbladder
- Stomach
- LB
- SB
8
Q
- Ascultation
- Use bell to listen for _
- What is the normal amount of bowel sounds/min
A
- Bruits
- 5-34 clicks/gurgles per min
9
Q
- Absent bowel sounds
A
- No bowel sounds for > 2 min
- Causes:
- Long lasting intestinal obstruction
- Intestinal perforation
- Mesenteric ischemia
10
Q
- Decreased bowel sounds
A
- None heard for 1 min
- Causes:
- Post surgical ileus
- Peritonitis
11
Q
- Hyperactive bowel sounds causes
A
- Diarrhea
- Early bowel obstruction
12
Q
- What are high pitched bowel sounds indicative of (raindrops on metal)
A
- Early intestinal obstruction
13
Q
- What are bruits heard in the abdominal aorta or other abdominal arteries suggestive of?
A
- Vascular obstruction
14
Q
- What is a friction rub?
- What is it indicative of?
A
- Abnormal grating spunds with respiratory . variation
- Inflammation of peritoneal surface of an organ (usually over liver or spleen)
15
Q
- Where should you listen for venous hum?
- What is this abnormal sound indicative of?
A
- Epigastric and umbilical regions
- Increased collateral circulation between portal and systemic venous systems
16
Q
- _ sound predominates when percussing the 4 quadrants of the GI tract. Why?
A
- Tympany
- Gas in Gi tract, scattered areas of dullness is normal for fluid and feces
Abnormal-large dull areas from mass or enlarged organ
Protuberant abdomen that is tympanic throughout may indicate intestinal obstruction
17
Q
- Tympany
A
- High pitched, air filled
18
Q
- Dullness
A
- Non-resonating, solid organs or masses
19
Q
- Resonance
A
- Hollow abdominal organs (lungs)
20
Q
- Hyper-resonance
A
- Air filled hollow organ (ie: pneumothorax)
21
Q
- Palpation
A
- Helpful for discerning abdominal tenderness. resistance, superficial organs and masses
- Use palmar aspect of hand with fingers together
- Gently then deeply palpate all 4 quads
- ALWAYS START FURTHEST FROM TENDER AREA
22
Q
- What two organs need additional assessment
A
- Liver
- Spleen
28
Q
- How do you test for ascities
A
29
Q
- How do you test for appendicitis
A
30
Q
- How do you test for biliary colic
A
31
Q
- How do you test for kidney inflammation/distension
A
47
Q
- Positioning for performing a rectal exam
A
48
Q
- Skin tags v external hemorrhoids
A
51
Q
- Most common viral causes of gastroenteritis
A
52
Q
- Most common causes of bacterial gastroenteritis
A
53
Q
- Most common cause of parasitic gastroenteritis
A
