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Pt Assess II Midterm > Abdominal Lecture > Flashcards

Abdominal Lecture Flashcards

1
Q

Where does the abdominal cavity extend from?

A

Just below diaphragm to the symphysis pubis

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2
Q

How are the 4 quadrants of the abdomen drawn?

A
  • Vertical line through umbilicus

- Horizontal across umbilicus

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3
Q

Define anorexia

A

Loss of appetite

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4
Q

What can early satiety indicate?

A

Gastric outlet obstruction
Hepatitis
Diabetic gastroparesis

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5
Q

What GI-related things can cause unintentional weight loss?

A
  • Malignancy
  • Malabsorption
  • Liver disease
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6
Q

Define dysphagia

A

Difficulty swallowing

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7
Q

Define odynophagia

A

Painful swallowing

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8
Q

How can heartburn radiate?

A

To neck and epigastrum

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9
Q

Mechanical causes of dysphagia

A
  • Stricture
  • Cancer or mass
  • Obstruction (FB)
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10
Q

Motor causes of dysphagia

A
  • Neuro disorder
  • Spasm
  • Scleroderma
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11
Q

If a patient points to their throat, they usually have a/an ___ problem

A

Transfer

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12
Q

If a patient points to their chest (and it is suspected GI related), then it is often a/an ____ problem

A

Esophageal

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13
Q

Define transfer dysphagia

A
  • Swallowing is attempted
  • Results in aspiration of food into nose/lungs
  • Suggests CNS problem
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14
Q

Define achalasia

A

Esophageal musculature does not relax enough

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15
Q

Regurgitation of food bolus suggests ____ problem

A

Mechanical

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16
Q

Intermittent solid to liquid mechanical dysphagia suggests:

A

Stricture

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17
Q

Intermittent solid then progressing to liquid mechanical dysphagia and progressively worsening with pain suggests:

A

Esophageal cancer

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18
Q

What are common causes of odynophagia?

A
  • Esophagitis (GERD induced)
  • FB
  • Pharyngitis (MC)
  • Achalasia
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19
Q

What is the MC cause of odynophagia?

A

Pharyngitis

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20
Q

Sharp and burning odynophagia suggests:

A

Mucosal inflammation (reflux esophagitis or infection)

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21
Q

Sharp and sticking odynophagia suggests:

A

Mechanical (fish or chicken bone)

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22
Q

Squeezing/cramping odynophagia suggests:

A

Muscular (esophageal spasm, achalasia)

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23
Q

Define regurgitation (GI)

A

Bringing up gastric contents without nausea or vomiting

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24
Q

What can cause fecal-like material to be vomited?

A

Small bowel blockage or fistula

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25
Q

Presence of bright red blood in vomitus indicates:

A

Esophageal or upper GI bleed

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26
Q

Presence of coffee ground material in vomitus indicates:

A

Partially digested blood (altered by stomach acid)

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27
Q

Prolonged vomiting will cause:

A

Fluid and electrolyte imbalance

28
Q

Aerophagia can cause:

A

Excessive belching/flatulence

29
Q

Define obstipation

A

Constipation occurring as a result of intestinal obstruction

30
Q

Large volumes of osmotic (watery) diarrhea can indicate:

A

Lactose intolerance

31
Q

Soft, watery with blood diarrhea indicates:

A

IBD (ulcerative colitis)

32
Q

Small, soft, watery w/o blood diarrhea indicates:

A

Crohn’s disease

33
Q

Melena means:

A

Blood has passed through digestive tract

black, tarry stools

34
Q

Jaundice can be accompanied with:

A

Severe itching

35
Q

Jaundice is caused by:

A

Hepatic disease or lysis of RBCs

36
Q

Jaundice causes elevated levels of ____ in the blood

A

Bilirubin

37
Q

How do urine and stool change with jaundice?

A
  • Urine becomes like tea

- Stools become light yellow or gray

38
Q

Stretching of liver capsule can cause ____ pain

A

Visceral

39
Q

Quality of visceral pain

A
  • Cramping colicky
  • Crescendo/decrescendo
  • Can be related to intestinal peristalsis
  • Usually not well localized by pt
40
Q

Severe visceral pain can be accompanied by:

A
  • NV
  • Sweating
  • Pallor
  • Restlessness (writhing)
41
Q

Function of mesentery

A

Acts as conduit for BV, nerves, lymphatics usually supported in layers of fat

42
Q

Describe parietal pain

A
  • Inflammation of parietal peritoneum
  • Aka somatic pain
  • Steady, aching, severe (worse than visceral)
  • Well localized
  • Aggravated by movement (pts lie still!)
43
Q

How does acute appendicitis pain present?

A
  • Initially, periumbilical visceral pain

- Gradually, parietal pain well localized to RLQ as inflammation spreads

44
Q

Define referred pain

A
  • Pain from original site radiates to distant site
  • Often at same spinal level as affected structure
  • May be superficial or deep
  • Well localized
45
Q

Abdominal pain is a (reliable/unreliable) guide to severity?

A

Unreliable - depends on patient

*Chronology may be more useful

46
Q

How is abdominal contour described?

A
  • Flat
  • Protuberant
  • Scaphoid
  • Obese
47
Q

Visible peristalsis can be an early sign of:

A

Obstruction

48
Q

Define diastasis recti

A

Separation of rectus abdominis muscles in midline creating a ridge when pt lifts head and shoulders off flat surface
*Not pathological

49
Q

Describe ascites

A

Free fluid collection in abdomen

50
Q

Hyperactive bowel sounds can indicate:

A
  • Diarrhea

- Early obstruction

51
Q

Hypoactive bowel sounds can indicate:

A
  • Paralytic ileus

- Early peritonitis

52
Q

Absent bowel sounds indicate:

A
  • Complete obstruction

- Late peritonitis

53
Q

Gas produces what note of percussion?

A

Tympanic

54
Q

Liquid produces what note of percussion?

A

Dull

55
Q

Solid produces what note of percussion?

A

Even more profound dullness than liquid

56
Q

Areas that contain both gas and fluid will produce what note of percussion?

A

Lower pitched tympanic

57
Q

Most notable areas of abdomen for percussion?

A
  • Gastric bubble (LUQ, tympanic)
  • Colonic splenic flexure (LUQ, low tympanic)
  • Liver (RUQ, dullness)
58
Q

What does abdominal muscular rigidity indicate?

A

Peritoneal irritation

59
Q

How are abdominal masses classified?

A
  • Physiologic (pregnant uterus)
  • Neoplastic (tumors)
  • Vascular (AAA)
  • Inflammatory (diverticulitis)
60
Q

What does rebound tenderness indicate?

A

Presence of peritoneal inflammation

61
Q

A normal size liver may be palpable up to ___ cm below the ____

A

3 cm below costal margin (in mid-clavicular line)

62
Q

Describe a normal liver edge

A

Smooth, soft

63
Q

What is the purpose of the scratch test?

A

Can help to locate lower liver margin

64
Q

Where does the spleen lie?

A

Between left 10th rib (LUQ)

65
Q

Purpose of psoas sign

A
  • Tests for appendicitis

- Abdominal pain occurs due to inflamed psoas muscle

66
Q

Describe Rovsing’s sign

A
  • Aka indirect tenderness
  • Rebound tenderness in LLQ
  • Positive in appendicitis

Pt Assess II Midterm (6 decks)

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