Abdominal Physical Exam Flashcards
How many Abdominal Quadrants and Regions
4 Quadrants: RUQ
LUQ
RLQ
LLQ
9 Regions: Epigastric,
L and R hypochondriac
L and R lumbar flank
L and R inguinal region
Umbilical
Hypogastric or suprapubic
ROS
Upper GI- Trouble swallowing Heartburn change in appetite N/V, regurgitation vomiting of blood indigestion
Stomach- epigastric abdominal pain food intolerance excessive belching or passing gas jaundice liver or gallbladder problems hepatitis
Lower GI- Changes in bowel habits rectal bleeding black tarry stools hemorrhoids constipation diarrhea
Abdominal Complaints
Acute vs chronic abdominal pain indigestion N/V- hematemesis anorexia, early satiety Dysphagia or Odynophagia change in bowel function diarrhea, constipation bloody stools jaundice
True or False?
Many patients will confuse suprapubic or flank pain as abdominal complaint
True
Urinary or Renal disorders
Suprapubic pain Dysuria ,Urgency, Frequency Hesitancy, split stream polyuria, nocturia Incontinence Hematuria Kidney or flank pain Ureteral Colic
Other abdominal complaints
Heartburn
Excessive Gas or Flatus
Anorexia-
regurgitation
vomiting
- burning at epigastric region radiating into throat; associated with REGURGITATION
- needing to belch; bloated
Abdominal fullness or early satiety
lack of appetite; unintentional weight loss
over a short or extended period of time
reflux of food and stomach acid back into the mouth w/ a brine-like taste
How: Retching- spasmodic movement of the chest and diaphragm
amount
type: food, green or yellow-bile, mucus, blood, coffee ground emesis ( hematemesis).
Abdominal pain - Qualify
Visceral pain
solid organs
- when hollow organs such as stomach, colon forcefully contract or become distended
- liver or spleen- pain when they swell against their capsule
- Gnawing, cramping, or arching
- Difficulty to localize
ie: Hepatitis
Parietal pain
-there is inflammation from the hollow or solid organs that affect the parietal peritoneum
- easily localized pain
ie: Appendicitis
Referred pain
- originates at different sites but shares innervation from the same spinal level
ie: pancreatitis pain at shoulder
Locations of pain
RUQ or Epigastric pain
Epigastric pain
Periumbilical pain
Hypogastric pain
Suprapubic or sacral
biliary tree and liver
stomach, Duodenum, or pancreas
from small intestine, appendix, proximal colon
the colon, bladder, or uterus
colonic pain diffuse
rectum
HPI- 7 attributes
1- location- point w one finger the area of pain
2- Quality- description on own words,
3-Quantity- rate severity on a scale from 1 to 10
4- setting
5- Timing- (onset) when it began
how frequent
how long it last
6- Radiation
7- Factors that aggravates or relieves
8- symptoms associated with painChanges in bowel movement
frequency
quality- diarrhea vs constipation
pain with BM
Blood or black stool
Hematochezia
Tarry stool
Melena
Jaundice stool
Icteric Sclerae
