Abdominal & G.I

Question 1

What organs can you percuss on the abdomen?

Answer 1

abdomen, liver, kidneys, and spleen

Question 2

What organs can you palpate on the abdomen?

Answer 2

liver, gallbladder, and spleen

Question 3

Palpate light for:

Answer 3

tenderness and muscle tone

Question 4

Palpate deep for:

Answer 4

pain, masses, and aortic pulsation

Question 5

What organ lies outside abdominal cavity but is
vital part of gastrointestinal (GI) system?

Answer 5

the esophagus

Question 6

What organs can be felt in the RUQ?

Answer 6

Liver/gall bladder, pylorus, duodenum, head of pancreas, right adrenal gland, portions of ascending/transverse colon

Question 7

What organs can be felt in the RLQ?

Answer 7

Lower pole of right kidney, cecum and appendix, portion of ascending colon, bladder (if distended), right ureter, right ovary and salpinx, uterus (if enlarged), right spermatic cord

Question 8

What organs can be felt in the LLQ?

Answer 8

Lower pole of L kidney, sigmoid colon, portion of descending colon, bladder (if distended), left ureter, left ovary/salpinx, uterus (if enlarged), left spermatic cord.

Question 9

What organs can be felt in the LUQ?

Answer 9

Left lobe of liver, spleen, stomach, ,body of pancreas, left adrenal gland, portion of left kidney, portions of transverse and descending colon

Question 10

ABDOMEN NORMAL ASSESMENT FINDING: Skin surface contour

Answer 10

Smooth, symmetric with centrally located umbilicus. Flat w/ scaphoid (drop beneath ribcage) in thin adults, pale pallor

Question 11

What does distension mean?

Answer 11

7Fs: (obesity, fetus, fluid, flatulence, feces, fibroid
tumor, fatal tumor)

Question 12

ABDOMEN NORMAL ASSESMENT FINDING: General Appearance

Answer 12

Well nourished, lying supine quietly with slow, even respirations, skin tone appropriate for race

Question 13

ABDOMEN NORMAL ASSESMENT FINDING: Auscultate bowel sounds

Answer 13

Notice presence of bowel sounds. No sounds for more than 4 minutes is absent. 30 sounds or more per minute is hyperactive. Normally vascular sounds are not heard.

Question 14

ABDOMEN NORMAL ASSESMENT FINDING: Light Palpation

Answer 14

No tenderness present. Abdominal muscles relaxed.

Question 15

ABDOMEN NORMAL ASSESMENT FINDING: Deep Palpation

Answer 15

No pain or masses. Aorta is often palpable at the epigastrium and above and slightly left of the umbilicus. Borders of the rectus abdominis can be felt, as can the sacral promontory and stool in the ascending and descending colon.

Question 16

Abdominal anatomical landmarks

Answer 16

Xiphoid process, costal margin, midline, umbilicus, anterosuperior iliac spine, umbilicus, burneys point, pouparts ligament, superior margin of os pubis (see picture for reference

Question 17

What order should you inspect abdomen?

Answer 17

Observe general appearance, visually inspect the abdomen, auscultate the abdomen, palpate the abdomen lightly, palpate the abdomen deeply

Question 18

Name some health history questions related to abdomen

Answer 18

1. DO you have any chronic diseases? If yes, describe.
2. Do you take any medications? If yes, what do you take and how often? What are the medications taken for?
3. Do you take any over the counter drugs or herbal supplements? If so, what do you take and how often? What are they for?
4. How often do you have a bowel movement? When was your last bowel movement? Describe the color and consistency of the stool.
5. What is your usual pattern of urination? When was the last time you urinated? Describe the color of the urine. Do you have any difficulty urinating?
6. Have you had problems with your abdomen or digestive system in the past? Esophagus? Stomach? Intestines? Liver? Gallbladder? Pancreas? Spleen? If yes, describe.
7. Have you had problems with your urinary tract in the past? If yes, describe.
8. Have you ever experienced the leaking of urine? When did this occur? Have you ever used pads, tissues, or cloth in your underwear to absorb urine?

Question 19

What are commonly reported problems of the abdomen and GI system?

Answer 19

Abdominal pain, Nausea and vomiting, indigestion/heartburn, abdominal distension, change in bowel habits, yellow discoloration of eyes or skin, problems with urination

Question 20

What are questions to ask about abdominal pain?

Answer 20

How long? Where? When did you first feel it? Describe the pain. Does it radiate? What aggravates/alleviates it? Is pain related to other symptoms? Pain associated with periods?

Determine which quadrant to see which organs may be causing pain. Sudden, severe pain may be linked to acute perforation, organ torsion, or inflammation. Pain radiation can indicate acute appendicitis (starts at umbilicus and move to RLQ), radiating back pain may occur from duodenal ulcers or pancreatitis. Pain from gall bladder may be right shoulder pain. If pain is worse with eating, it could be gastroenteritis and/or IBS. Pancreatitis can be relieved by hugging knees to chest. Appendicitis is relieved by lying still. Pain relief after a bowel movement may be diverticulitis. Constipation could be bowel obstruction. Dysmenorrhea may be caused by a increase in prostaglandin.

Question 21

What are questions to ask about nausea and vomiting?

Answer 21

How long/often do you vomit? How much? What does it look like?

Vomiting that precedes abdominal pain suggests infection as possible cause. Abdominal pain that precedes vomiting may be appendicitis. Just stomach content means acute gastritis. Obstruction of the bile duct results in greenish-yellow vomit. Intestinal obstruction has a poop smell to it. Blood may be gastric or duodenal ulcers. Pregnant women have high serum levels of chorionic gonadotropin which stimulates vomiting. Liver diseases may turn stool brown to tan. hepatitis infection may cause fever and chills.

Question 22

What are questions to ask about indigestion/heartburn?

Answer 22

How long after eating? Where is the discomfort? Change in color of poo/pee? How long has it been happening? How often? What relieves these symptoms?

After eating heartburn is GERD. Angina or a myocardial infarction may appear as indigestion that isn’t relieved by antacids.

Question 23

What are questions to ask about abdominal distension?

Answer 23

How long? Come and go? Related to eating? Relieves/exacerbates?

Slow increase in size and no relief without pooping is constipation. Ascites is progressive. Loss of appetite could mean cirrhosis and malignancy.

Question 24

What are questions to ask about change in bowel habits?

Answer 24

Describe change. Frequency. Consistency of stool. First notice change.

Changes in bowel movements is one of the seven signs of cancer. Watery diarrhea containing blood, mucus, or pus can indicate ulcerative colitis. Abdominal cramping with diarrhea may indicate gastroenteritis. More fat in stool may indicate pancreatitis.

Question 25

What are questions to ask about yellow discoloration of the eyes/skin?

Answer 25

When did you first notice? Blood transfusion or tattoos in the past year? Eat shellfish? Color of urine changed?

Jaundice could be caused by liver disease or obstruction of bile flow from gallstones. Yellow skin with fever and vomiting could be hepatitis.

Question 26

What are questions to ask about problems with urination?