Abdominal Examination Flashcards
What are the four steps of abdominal examination?
- ) Inspection
- ) Auscultation
- ) Percussion
- ) Palpation
What is Grey Turner’s Sign?
flank ecchymosis (bruising) due to hemorrhage
What is Cullen Sign?
ecchymosis around the umbilicus due to hemorrhage
Describe normal bowel sounds?
5 - 34 clicks or gurgles per minute
Describe abnormal bowel sounds?
high pitched sounds
decreased or absent sounds
What are the vascular sounds that can be heard over the abdomen?
Aortic artery
Renal artery
Iliac artery
Femoral artery
Where would your percussion bring about a dull sound in the abdomen?
over solid organs: liver or spleen
Feces
Over fluid in the peritoneum
Where would your percussion bring about a tympanic sound in the abdomen?
air-filled viscera (majority of abdomen)
What is the expected liver span?
6 - 12 cm along the mid-clavicular line
What is the expected spleen span?
from ribs 6 - 10 at the left mid-axillary line
Differentiate light, moderate, and deep palpitation?
light - 1 cm
moderate - 2 to 3 cm
deep - 3 cm
What does rebound tenderness indicate?
peritoneal inflammation
What does rebound tenderness at McBurney’s point indicate?
possible appendicitis
What is Rovsing’s Sign?
pain in RLQ while applying pressure to the LLQ
indicates appendicitis
What is the Iliopsoas Muscle Test? What’s a positive test and what does it indicate?
patient flexes hips at thigh against resistance
positive test: pain
Indicates: irritation of the psoas muscle due to inflammation of appendix
What is the Obturator Muscle Test? What’s a positive test and what does it indicate?
patient’s right thigh is flexed (knee bent), hip rotated internally
positive test: right hypogastric pain
Indicates: irritation of the obturator muscle due to inflammation of the appendix
What is the Heel Strike Test? What’s a positive test and what does it indicate?
patient supine, strike patient’s right heel
positive test: abdominal pain
Indicates: appendicitis or peritonitis
How do you palpitate the liver?
patient supine, put your left hand below 11th and 12th rib.
with right hand direct fingertips cephalicly
have patient inhale
push down and up
What is Murphy’s Sign? What’s a positive sign and what does it indicate?
palpate deeply under the right costal margin during inspiration to palpate the gallbladder
positive sign: pain
Indicates: acute cholecystitis
What is Courvoisier’s Sign? What’s a positive sign and what does it indicate?
positive sign: an enlarged, but non-tender gallbladder
indicates: pancreatic disease/cancer
How do you palpate the spleen?
pt. supine
place right hand under left rib cage
gently press inward and downward below left costal margin
(normal spleen should not be palpable)
What is:
Lloyd punch
Kidney Punch
Costovertebral Angle tenderness (CVA)? What’s a positive test and what does it indicate?
patient sitting, tap the area of the back overlying kidneys
positive test: pain
Indicates: infection around kidney, renal stone
How do you palpate the aorta?
palpate just above the umbilicus slightly left of midline
Aorta should be 2 - 3cm in width
pulsation should be anterior-inferior
