Abdominal Exam (Lecture) Flashcards
Which vertebral levels will you look for Somatic Dysfunctions associated with each part of the GI tract?
UPPER GI: T5-9
LOWER GI: T10-11
PELVIC structures: L1-3
When is a Rectal Exam indicated?
- Blood in the Stool
- Constipation with Abdominal Pain
- Enlarged Prostate
What are some good “onset” questions for a patient presenting with Abdominal Pain?
- When did the pain start?
- What were you doing when it started?
- Did it come on sudden or gradual?
- Was anything different in the few days or weeks leading up to the abdominal pain?
Why might a patient with abdominal pain also have problems with their joints?
The Patient could have an AUTOIMMUNE disorder that effects the abdomen as well as the joints!
What are some important aspects to obtain in the SOCIAL history when you suspect abdominal pain?
- Diet, exercise
- Alcohol, Tobacco, Recreational Drug use
- Occupation
- Stress
- Travel
What do you have to do with the patient every time you perform an abdominal exam?
DRAPE THE PATIENT!
Striae are associated with which syndrome?
Cushing’s SYNDROME
What can happen with an umbilical hernia?
Portions of the intestine can slip through the abdominal wall and become strangulated/necrosis!
Cullen’s Sign is associated with which pathology?
Internal bleeding of the PANCREAS!
What are some signs of portal hypertension/chronic liver disease?
- Jaundice
- Ascites
- Caput Medusae
Describe ABRNORMAL bowel sounds.
- ABSENT bowel sounds: None for > 2 minutes (Long-Lasting intestinal obstruction, intestinal perforation, mesenteric ischemia)
- DECREASED bowel sounds: None for 1 minute (Post-surgical ileus, peritonitis)
- INCREASE bowel sounds: DIARRHEA, early bowel Obstruction
- HIGH PITCHED bowel sounds: Suggests EARLY intestinal obstruction
- FRICTION RUB: Grating sound with respiratory variation (Inflammation of the PERITONEAL surface of an organ; Listen over LIVER and SPLEEN)
- Venous hum: Increased collateral circulation between portal and systemic venous systems (Listen over EPIGASTRIC and UMBILICAL regions)
What are the different sounds associated with Percussion?
- Tympany: High-Pitched, air filled
- Dullness: Non-resonating, solid organs or masses
- Resonance: Lungs
- Hyper-resonant: Pneuomothorax
What’s the main rule of Palpation?
Start FURTHEST away from the TENDER area
What are some examples of visceral pain?
- RUQ Visceral Pain: LIVER distension against its capsule with alcoholic hepatitis
- Periumbilical visceral pain: Acute APPENDICITIS
What are some examples of parietal pain?
- RUQ/epigastric parietal tenderness: Acute Cholecystitis
- Epigastric parietal tenderness: Acute pancreatitis
- RLQ parietal tenderness: LATER finding in acute APPENDICITIS
- LLQ parietal tenderness: Acute Diverticulitis
