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Medical Lectures > Abdominal Examination > Flashcards

Abdominal Examination Flashcards

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USMLE® Step 1 flashcards
1
Q

Main Methods of Medical Exam

A

Inspection (observation)
Percussion
Palpation
Auscultation

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2
Q

Abdominal exam

A

Inspection
Auscultation
Percussion
Palpation

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3
Q

Major Landmarks

A 
Costal margins
Anterior superior iliac spine
Midline – indicated by the linea alba
Inguinal ligament
Symphysis pubis
Rectus abdominus
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4
Q

4 quandrants

A

Right upper quadrant (RUQ)
Left upper quadrant (LUQ)
Right lower quadrant (RLQ)
Left lower quadrant (LLQ)

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5
Q

How many different regions?

A

9

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6
Q

What are the 3 midline areas?

A

Epigastric
Umbilical
Hypogastric or suprapubic

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7
Q

What is in the RUQ?

A

liver, the gall bladder, duodenum the upper portion of the pancreas and the hepatic flexure of the colon

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8
Q

What is the RUQ tender with?

A

hepatitis, cholecystitis and with the formation of a peptic ulcer

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9
Q

What do doctors asses with the RUQ?

A

localize pain and tenderness

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10
Q

What forms the LUQ?

A

the median plane extending to the left of the patient and with the umbilical plane to the left rib cage

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11
Q

What is found in the LUQ?

A

stomach, the spleen, the left portion of the liver, and the main body of the pancreas. The left portion of the kidney and the adrenal gland are also found in this quadrant. The splenic flexure of the colon and the bottom portion of the colon also sit in the left upper quadrant

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12
Q

What is the LUQ tender with?

A

appendicitis and abnormalities of the intestines such as malrotation

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13
Q

Borders of LLQ:

A

below the umbilicus plane

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14
Q

Organs in LLQ:

A

the bottom portion of the colon, the sigmoid colon, the left ovary, Fallopian tube and the left uterine tube

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15
Q

Pain in the LLQ can be a symptom of:

A

Abdominal pain in the LLQ may be a symptom of colitis, diverticulitis, or ureteral colic. Pain in this region may also be caused by ovarian cysts or a pelvic inflammation. Tumors found in this region can be serious determinants of colon or ovarian cancer

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16
Q

Regions of abdominal area

A 
right hypochondriac
right lumbar
right iliac
eipgastric
umbilical
hypogastric
left hypochondriac
left lumbar
left iliac
17
Q

What should be inspected?

A

scars, lesions, rashes, or striae (stretch marks).

18
Q

What can indicate Cushings?

A

Purple-pink striae

19
Q

What should be observed with the umbilicus?

A

Should be midline
Look for hernia
Inverted or everted

20
Q

What is the normal range of sounds?

A

5 and 34 clicks or gurgles per minute

21
Q

Bruits

A

sounds of turbulent arterial flow - atherosclerosis

22
Q

What should be listened?

A

Renal arteries

Iliac arteries

23
Q

What has a dull sound?

A

solid or liquid filled structure

24
Q

What has a resonant sound?

A

air filled

tympanitic- stomach

25
Q

How do the tones change when percussing the abdomen?

A

resonant: lung
dull: liver
resonant: intestines

26
Q

What should be noted with palpation?

A

guarding, tenderness, rigidity, or masses

27
Q

Order of palpation?

A

start R lower - R upper - L upper - L lower

28
Q

Normal width of the aorta?

A

2.5-3.0 cm

29
Q

Positive rebound sign:

A

If pain is worse on withdrawal than on initial palpation

30
Q

What is the psoas sign an indication of?

A

appendicitis

31
Q

Psoas Sign:

A

Resist hip flexion of the right leg in supine
With patient left sidelying, passively stretch the right hip into extension
Positive if it elicits abdominal pain

32
Q

What is Murphy sign an indication of?

A

acute cholecystitis

33
Q

Murphy Sign:

A

Hook left thumb or fingers of your right hand under the right costal margin where lateral border of rectus meets costal margin
Have patient take a deep breath
Positive if the patient has a sharp increase in tenderness with a sudden stop in inspiratory effor

34
Q

Emergency situation:

A

Visible of palpable pulsatile mass in the epigastric area – suspected large abdominal aortic aneurysm (AAA)
Positive rebound sign or other signs of peritoneal inflammation

Medical Lectures (11 decks)

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