Abdominal System - Class Notes Flashcards
If there’s an obstruction to the aorta, what organs will affected directly
Spleen, Kidneys, Liver
Where are the right and left iliac arteries?
lower branches of the aorta
What is Viscera?
refers to the soft and internal organs
What is Peritoneum?
Layer of tissues that line the abdominal cavity and organs
What is Striae?
Stretch marks
What is Ascites?
abnormal fluid in the peritoneal cavity
What are Keloids?
A type of raised scar resulting from excessive scar tissue growth
What is Hepatomegaly?
enlarged liver
What is Splenomegaly?
enlarged spleen
Sound for percussion over the abdomen?
tympanic
Sound for percussion over an organ?
dull
What is CVA tenderness?
Costal-vertebral angel tenderness
What is AAA?
Abdominal Aortic aneurysm
What is Peristalsis?
Involuntary contractions and relaxation of muscles in the GU
What is Hernia
bulging of an internal organ through a weak area (usually in the abdomen)
What is Anastomosis
a surgical connection
What is Fistula?
Abnormal opening/passage between two organs or systems
What is Ulcer?
open sore
What is Barretts Esophagus?
Conditions where tissue is similar to the lining of the intestine replaces the usual esophageal - associated with cirrhosis
What is Polyps
abnormal growth of o cells protrudes from the surface
What is Diverticula?
inflammation; pockets can rupture; small bulging pouches or sacs that form on the lining of the colon
Candida
fungal infection
BRBPR
bright red blood per rectum
Hematochezia
Passage of fresh blood per anus (in
the stool usually)
Hemorrhoids
Swollen veins around anus/rectum
Melena
black tarry stool
Odynophagia
Painful swallowing
EGD
Procedure of the upper GI tract. Also
called an “upper endoscopy.”
Proctitis
Inflammation of the rectal lining
Flatulence
passage of intestinal gas
Tenesmus
A persistent, painful urge to defecate
without excreting stool
Borborygmus
Gurgling, rumbling sound from abdomen
Colostomy
Surgical opening of the colon to the
abdomen
Indigestion
Also called dyspepsia or an upset stomach.
Sensation of abdominal discomfort
Anal fissure
Small tear in the thin, moist skin that lines
the opening of the anus
What is solid viscera? give examples
do not change shape (ex. liver, spleen, pancreas, uterus, ovaries, adrenal glands)
What is hollow viscera? give examples
changes shape (ex. stomach, gallbladder, intestines, bladder, sigmoid colon)
What causes pain in the abdomen?
inflammation, infection, distention, stretching, pressure, obstruction, or trauma
How might your patient describe visceral pain?
dull, aching, burning, cramping, colicky, poorly defined, or localized
- intermittent pain
- secondary to distention of hollow organs or stretching of capsules of hollow organs
How might your patient describe parietal pain?
localized more to the source, severe, steady
- inflammation of the parietal peritoneum, such as in appendicitis and peritonitis
How might your patient describe Referred pain?
distant site
- gallbladder: pain can be in the shoulder, mid back, or right side
Why would Cough be significant in HPI of the abdomen?
GERD, aspiration, swallowing defects
Physical Exam Order for the Abdominal Assessment
Inspect, Auscultate, Percuss, Palpate
When you auscultate do you listen clockwise or counterclockwise and which quadrant do your start?
start at RLQ and go clockwise
Which part of the stethoscope do you listen to for bowel sounds?
diaphragm
Which part of the stethoscope do you listen to for vascular sounds?
bell
What is Cullens’s sign?
bluish or purple discoloration around the umbilicus
What is Turner’s sign?
indicates bleeding without the abdominal wall, possibly from trauma
Hyperactive bowel sounds
gurgling, high pitched, rapid peristalsis as in gastroenteritis and diarrhea - could be the beginning of a bowel obstruction
Hypoactive bowel sounds
very quiet, almost nonexistent; very faint
Decreased or absent bowel sounds
absence of bowel motility; may indicate an emergency
How long for a true absent bowel sound?
no sound for 5 minutes
Bruit
turbulence; low pitched murmur-like sound; not usually heard over abdominal aorta, or renal, iliac or femoral arteries - may indicate occlusive artery disease, renal artery stenosis
Venous hum
continuous roaring or whining sound heard over the epigastric area - can be secondary to liver disease with portal vein hypertension
Friction rub
may be heard over right and left lower rib cage, liver, and spleen area - may indicate cancer
When is percussion contraindicated?
suspected aortic aneurysm, appendicitis, abdominal organ transplants
What is the most common sound heard in most of the abdominal area?
tympany
Indirect percussion
Middle finger of nondominant hand with use of middle finger of dominant hand to strike with two quick taps
Blunt percussion
- One hand flat on surface, struck by fist of other hand
- Looking for CVA tenderness
Direct percussion
- Directly tapping body part with one or two fingers
- Checking for tenderness
Abnormal finding: palpation of the abdomen - what can this indicate?
tenderness, guarding, rigid abdomen
- peritoneal irritaiton, cholecystitis, splenomegaly, hepatomegaly, urinary retention, masses
Test for Cholecystitis?
Murphy’s sign
Blumberg sign
rebound tenderness
Rovsing’s sign
test for referred rebound tenderness
- pain in the RLQ during pressure in the LLQ
McBurney’s Point
2/3 distance from the navel
- acute appendicitis
Name considerations for older adults (6)
- Sensitivity to pain may diminish
- Decline in appetite
- Increased risk of UTI/diarrhea
- Dilated superficial capillaries
- Changes to width of aorta secondary to HTN
- Need for screening of abdominal aortic aneurysm
