ASSESSING ABDOMEN Flashcards
1
Q
The abdomen is bordered superiorly by what?
A
Costal margins
2
Q
The abdomen is inferiorly bordered by what?
A
Symphyis pubis and inguinal canals
3
Q
The abdomen is laterally bordered by what?
A
Flanks
4
Q
The quadrants are determined by an imaginary vertical line which is the midline extending from where?
A
From the tip of the sternum called xiphoid through the umbilicus to the symphyis pubis.
5
Q
The vertical line or midline is bisected perpendiculalrly by the lateral line which runs through the?
A
Umbilicus across the abdomen
6
Q
What are the three regions on the top of the abdomen?
A
right epigastric
epigastric
left epigastric
7
Q
What are the three regions on the middle of the abdomen?
A
Left umbilical
Umbilical
Right Umbilical
8
Q
What are the three regions on the inferior abdomen?
A
left hypogastric
hypogastric
right hypogastric
9
Q
What is the other name of Hypogastric?
A
Suprapubic
10
Q
The abdominal contents are enclosed externally by what muscle?
A
Abdominal wall Musculature, which includes three layers of muscle
11
Q
What is the outermost layer of the abdominal wall Musculature?
A
External abdominal oblique
12
Q
What is the middle layer of the abdominal wall Musculature?
A
Internal abdominal oblique
13
Q
What is the innermost layer of the abdominal wall Musculature?
A
transverse abdominis
14
Q
Connective tissue from these muscles extends forward to encase a vertical muscle
of the anterior abdominal wall called the?
A
Rectus Abdominis
15
Q
How do we call the connective tissue extensions of these muscles?
A
Aponeuroses
16
Q
Connective tissue
from these muscles extends forward to encase a vertical muscle
of the anterior abdominal wall called the?
A
Linea Alba
17
Q
Where is the Linea Alba located?
A
It extends from the sternum to the symphyis pubis.
18
Q
What do we call the thin, shiny, serous membrane that lines the abdominal cavity or parietal peritoneum?
A
Peritoneum
- it also provides a protective covering for most of the internal abdominal organs
19
Q
A
20
Q
Within the abdominal cavity are structures of several different body systems: gastrointestinal, reproductive (female), lymphatic, and urinary. These structures are typically referred to as the?
A
Abdominal Viscera
21
Q
What are the two types of abdominal viscera?
A
a. solid viscera
B. hollow viscera
22
Q
What is solid viscera vs hollow viscera?
A
Solid viscera are those organs that maintain their shape consistently like liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus. While hollow viscera consist of structures that change shape depending on their contents like the stomach, gallbladder, small intestine, colon, and bladder.
23
Q
The abdominal viscera are palpable depending on what 3 factors?
A
location
structural consistency
size
24
Q
Where is the liver located?
A
Below the diaphragm in the right upper quadrant of the abdomen.
25
What are the functions of the liver?
It functions as an accessory digestive organ and has a variety of metabolic and regulatory functions as well, including glucose storage, formation of blood plasma proteins and clotting factors, urea synthesis, cholesterol production, bile formation, destruction of RBC, storage of iron and vitamins, and detoxification.
26
What parts of the body does the right upper quadrant have?
-Ascending and transverse colon
-Duodenum
-Gallbladder
-Hepatic flexure of colon
-Liver
-Head of the pancreas
-Pylorus - closes and opens during digestion - a door to the intestines
-Right adrenal gland
- right kidney (upper pole)
- right ureter
27
What parts of the body does the Right lower quadrant?
- appendix
- Ascending colon
-cecum
-right kidney (lower pole)
-right ovary and tube
- right ureter
- right spermatic cord
28
What parts of the human body does the Left Upper Quadrant have?
-Left adrenal gland
- Left kidney (upper pole)
- left ureter
-pancreas (body and tail)
-spleen
-splenic flexure of colon
-stomach
-transverse descending colon
29
What parts of the body does the Left Lower Quadrant have?
- Left kidney (lower pole)
- left ovary and tube
- left ureter
- left spermatic cord
- descending and sigmoid colon
30
What parts of the body is located in the Midline?
- bladder
- uterus
- prostate gland
31
What are the 2 functions of the pancreas?
1. It is an endocrine gland
2. An accessory organ of digestion
32
Where is the spleen specifically located and how wide it is?
Spleen is approximately
7 cm wide and is located above the left kidney just below the
diaphragm at the level of the ninth, tenth, and eleventh ribs. It is posterior to the left mid-axillary line and posterior and lateral to the stomach.
33
What happens when the spleen enlarges?
It's lower tip extends down and toward the midline.
34
What are the functions of the spleen?
It filters the blood of cellular debris, to digest microorganisms, and to return the breakdown products to the liver.
35
Where is the kidneys specifically located?
Located high and deep under the diaphragm which is approximate with the level of the T12 to the L3 vertebrae.
36
Where is the kidney tenderness best assessed?
Costcovertebral angle
37
Why is the right kidney slightly lower than the left?
Because of the position of the liver.
38
What are the functions of the kidneys?
It's main function is to filter and eliminate metabolic waste products. It also play a role in blood pressure control and maintenance of water, salt, and electrolyte balances. Lastly, it function as an endocrine gland by secreting hormones.
39
Where is the pregnant uterus palpated?
Above the level of the symphysis pubis in the Midline.
40
When are the ovaries best palpated?
Only during bimanual examination of the internal genitalia.
41
Where is the stomach located?
In the left upper quadrant just below the diaphragm and between the liver and spleen.
42
Where is the gallbladder located and what is its function?
Near the posterior surface of the liver lateral to the mid-clavicular line. Concentrates and store bile needed to digest fat.
43
How long and wide is the small intestine?
it is 7 meters long and 2.5 cm wide.
44
What are the 2 major functions of the small intestine?
Digestion and absorption of nutrients through millions of mucosal projections lining its walls.
45
How long and wide is the colon or the large intestine?
Approximately 6 cm wide and 1.4 meters long.
46
Where does the colon originates from and where it atteches to the small intestine?
Originates from the RLQ and attaches to the ileocecal valve of the small intestine.
47
What are the functions of the Colon or the large intestine?
Secretes large amounts of alkaline mucus to lubricate the intestine and neutralize acids formed by the intestinal bacteria. Water is also absorbed in this part leaving waste products to be eliminated in stool.
48
Where is the urinary bladder located?
Behind the pubic bone in the Midline of the abdomen.
49
What supplies abdominal organs with blood?
Abdominal Aorta and it's major branches.
50
Why does abdominal pain occurs?
when specific digestive organs or structures are affected by
chemical or mechanical factors such as inflammation, infection, distention, stretching, pressure, obstruction, or trauma.
51
Define Pyrosis and it's possible indications.
It is known as indigestion often described as heartburn which can indicate acute or chronic gastric disorders like acidity, GERD, ulcers, and stomach cancer.
52
What is hematemesis?
Vomiting with blood which is seen with esophageal varices or duodenal ulcers.
53
What is the medical term for description of vomits?
Emesis
54
This are hormone-like substances that help protect the stomach lining from the stomach acid?
Prostaglandins
55
What is "brain gut axis"?
It is when people feel their stress in their gut.
56
What are the 3 types of Pain?
Visceral pain
Parietal pain
Refered pain
57
Occurs when the parietal peritoneum becomes
inflamed, as in appendicitis or peritonitis. This type of pain
tends to localize more to the source and is characterized as
a more severe and steady pain.
Parietal Pain
58
Occurs when hollow abdominal organs—such
as the intestines—become distended or contract forcefully,
or when the capsules of solid organs such as the liver and
spleen are stretched. Poorly defined or localized and intermittently timed, this type of pain is often characterized as
dull, aching, burning, cramping, or colicky.
Visceral Pain
59
Occurs at distant sites that are innervated at
approximately the same levels as the disrupted abdominal
organ. This type of pain travels, or refers, from the primary
site and becomes highly localized at the distant site.
Referred Pain
60
Why do we initially auscultate before Palpating in assessing the abdomen?
In order not to alter the pattern of client's bowel sounds.
61
What are the common abnormal findings?
• Abdominal edema, or swelling, signifying ascites
• Abdominal masses, signifying abnormal growths or constipation
• Unusual pulsations such as those seen with an aneurysm of
the abdominal aorta
• Pain associated with appendicitis
62
An abnormal finding of purple discoloration at the flanks or known as Grey-Turner sign indicates what?
Indicates bleeding within the abdominal wall, possibly from trauma to the kidneys, pancreas, or Duodenum or from pancreatitis.
63
An abnormal finding of pale and taut skin can be seen with what? and its indication?
Ascites which is a significant abdominal swelling indicating fluid accumulation in the abdominal cavity.
64
An abnormal finding of dilated veins can signify what?
-Liver Ciirhosis
-Obstruction of the inferior vena cava
-portal hypertension
-ascites
65
This is when the arterioles and capillaries are dilated and has a central star which can be seen with liver disease or portal hypertension.
Spider Angioma
66
TRUE OR FALSE:
Dilated supercial capillaries without a pattern may be seen with older clients.
TRUE
67
What do you mean by vascularity of the abdominal skin?
It means you are assessing the scattered veins, arteries, or blood vessels in general if they are normal.
68
What is striae in layman's term?
Stretch marks
69
What color is the striae of a patient with a Cushing's syndrome?
Colored dark bluish-pink
70
What is a petechiae?
These are bleeding moles or reddish/purple lesions which are abnormal.
71
A bluish or purple discoloration around the umbilicus is a sign of what? also known as what? and indicates what?
It is a Cullen's sign which is also known as periumbilical ecchymosis that indicates intra-abdominal bleeding.
72
What can cause a deviated umbilicus?
A deviated umbilicus may be caused by pressure from a mass, enlarged organs, hernia, fluid, or scar tissue.
73
TRUE OR FALSE:
The contour of the umbilicus is reverted and non protruding. It is 0.5 cm and round or conical in shape.
FALSE
The contour of the umbilicus is recesses or inverted or protruding no more than 0.5 cm, and is round or conical.
74
Differentiate abdominal distention and umbilical hernia.
Abdominal distention causes everted umbilicus while umbilical hernia causes an enlarged reverted umbilicus
75
How do we properly inspect the pt's abdominal contour?
Sitting at the client’s side, look across the abdomen at a
level slightly higher than the client's abdomen. Inspect the area between the lower ribs and pubic bone. Then measure abdominal girth as indicated.
76
A distended or stretched out of normal na abdomen may be due to what?
obesity
gas - air
fluid accumulation
77
A distention below the umbilicus may be duw to what?
Full bladder
uterine enlargement
ovarian tumor/cyst
78
A distention of the upper abdomen may be seen with what?
Masses of the pancreas or gastric dilation
79
The major cause of abdominal distention are sometimes referred to as the "6 fs" which are?
Fat
Feces
Fetus
Fibroids
Flatulence
Fluid
80
What is a scaphoid abdomen?
A scaphoid abdomen is a sunken abdomen that may be seen with severe weight loss or cachexia related to starvation or terminal illness.
81
As symmetry in the abdomen can be seen with what?
Asymmetry may be seen with organ enlargement, large masses, hernia, diastasis recti, or bowel obstruction.
82
If patient Alfred has a protrusion of his bowel through the abdominal wall making it looked like it is bulging, what does he have?
Patient Alfred has a hernia
83
What does patient Mirakel have when there is bulging seen between his vertical midline separation of her Abdominis rectus muscles?
Patient Mirakel has a Diastasis recti
84
Patient Seven reflects peritoneal irritation. Which means?
Patient Seven changes to thoracic breathing or has a diminished abdominal respiration.
85
What does it mean when a person has a vigorous, wide, exaggerated pulsations?
When he/she has vigorous, wide, exaggerated pulsations in the abdomen.
86
TRUE OR FALSE:
A slight pulsation of the abdominal aorta, which is visible in the epigastrium, extends full length in thin people.
TRUE
87
TRUE OR FALSE:
In auscultation for bowel sounds, we make use of the bell and we begin in the RUQ and proceed clockwise.
FALSE
In auscultating bowel sounds, we make use of diaphragm and we begin in the RLQ then continue through a clockwise pattern covering all quadrants.
88
Hyperactive bowels are normally heard sometimes which is referred to as?
"borborygmus" which are loud, prolonged gurgles characteristics of one's "stomach growling". It has a rate of 5-30 per minute
89
Differentiate hyperactive and hypoactive bowel sounds.
Hyperactive bowel sounds are rushing, tingling, and high pitched while Hypoactive indicates diminished bowel motility.
90
Hyperactive bowel sounds can be hard in what?
Can be heard in early bowel obstruction, gastroenteritis, diarrhea, or with use of laxatives.
91
Hypoactive bowel sounds can indicate what?
Common cause include paralytic ileus due to abdominal surgery, inflammation of the peritoneum, or late bowel obstruction. Can also occur in pneumonia.
92
Where are bowel sounds best heard?
Bowel sounds may be more active over the ileocecal valve in the Right Lower Quadrant.
93
As future nurses, what do we take note of in the bowel sounds of a patient?
We must note the intensity, pitch, and frequency of the sounds.
94
Using the bell, where do we listen for venous hum?
In the epigastric and umbilical areas. Normally none is heard but if a Hum is heard, it suggest increased collateral circulation between the portal and systemic venous systems as in cirrhosis of the liver
95
How do we auscultate for a friction rub over the liver and spleen?
We listen over the right and left lower rib cage using the diaphragm.
96
If a friction rub is heard over Abby's lower right costal area, what possibly does she have?
Hepatic abscess or metastases
97
A rub is heard over the anterior axillary line in the lower left costal area of Danoy, what is possibly the causes?
Associated with splenic infarction, abscess, infection, or tumor.
98
Upon percussion of the abdomen, where do we hear tympanic and dullness sounds?
Generalized tympany predominates over the abdomen because of air in the stomach and intestines. Dullness is heard over the liver and spleen.
99
When an abdomen is gaseous and distended, what sound is actually heard?
Accentuated tympany or hyperresonance
