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Health Assessment > Assessing the Abdomen > Flashcards

Assessing the Abdomen Flashcards

1
Q

abdomen anatomy

A

four quadrants. abdominal wall muscles

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2
Q

four quadrants

A

RLQ, RUG, LLQ, LUQ

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3
Q

Abdominal wall muscles - three layers

A

external abdominal oblique (outer), internal abdominal oblique (middle), transverse abdominis (inner layer)

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4
Q

internal anatomy

A

peritoneum - thin shiny serous membrane, lines abdominal cavity, provides protection of internal abdominal organs

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5
Q

solid viscera

A

liver, pancreas, spleen, kidneys, uterus, ovaries

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6
Q

pancreas

A

not normally palpable, endocrine gland, accessory organ of digestion

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7
Q

spleen

A

not normally palpable, filter blood of cellular debris, digest microorganisms, return breakdown products to liver

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8
Q

kidneys

A

filter blood

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9
Q

Hollow viscera

A

stomach, gallbladder, small/large intestine, urinary bladder

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10
Q

What do hollow viscera do?

A

store things for the body

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11
Q

vascular structures

A

perfusion by abdominal aorta/major branches, pulsations of aorta frequently visible/palpable midline in upper abdomen, pulsations of right/left iliac arteries may be felt in RLQ/LLQ

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12
Q

History of present concern

A

any abdominal pain (COLDSPA), indigestion (COLDSPA), n/v - triggers, increase/decrease in appetite - weight/BMI change/extended illness causing weight increase/decrease, yellowing of skin/sclera - jaundice, bowel elimination

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13
Q

bowel elimination

A

describe stools, change in pattern, constipation/accompanying symptoms, diarrhea/accompanying symptoms, clay colored stool - liver disease

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14
Q

Personal health history

A

any GI disorders, UTIs, viral hepatitis - abc, surgery/trauma, OTC

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15
Q

Family history

A

GI cancer, other GI disorders

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16
Q

lifestyle

A

alcohol, types of food, exercise, stress - affect eating/elimination, current GI disorder/how affecting lifestyle

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17
Q

abdominal pain terms

A

visceral, parietal, referred pain

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18
Q

visceral pain

A

when hollow abdominal organs become distended or contract forcefully, or capsules of solid organs stretched. poorly defined - dull, aching, burning

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19
Q

parietal pain

A

parietal peritoneum becomes inflamed. ex: appendicitis or peritonitis - localized, severe, steady

20
Q

referred pain

A

distant sites that are innervated at approximately same levels as disrupted abdominal organ, travels from primary site to become highly localized at distant site

21
Q

physical assessment

A

routine screening. inspection, auscultation, percussion, palpation

22
Q

Routine screening includes

A

observe color, vascularization, scars, rashes, lesions of abdomen, observe umbilicus, abdominal contour/symmetry, aortic pulsations/peristaltic waves, auscultate bowel sounds, percuss four quadrants, lightly palpate four quadrants

23
Q

inspection

A

observe color, note vascularity, note striae, scars, lesions/rashes, umbilicus should be midline at lateral line, contour of umbilicus, abdominal contour, abdominal symmetry - supine, signs of hernia/mass/diastasis recti - raise head, abdominal movement when breathing, aortic pulsations, peristaltic waves

24
Q

new striae are

A

pink or blue

25
Q

old striae are

A

silvery, white, linear, uneven stretch marks

26
Q

Abdominal contour

A

flat, rounded, scaphoid, should be evenly rounded

27
Q

Aortic pulsations

A

slight pulsation of abdominal aorta in epigastrium full length in thin people

28
Q

Peristaltic waves

A

normally not seen, maybe if thin, abnormal in LUQ or RLQ - obstruction

28
Q

Auscultate bowel sounds

A

diaphragm of stethoscope, warm, start RLQ/proceed clockwise, 5 min before document no bowel sounds, minimum 1 min per quadrant to confirm no bowel sounds, normally every 5-15 sec. note intensity, pitch, frequency

29
Q

Auscultate vascular sounds

A

bell, listen for bruits (abnormal), auscultate abdominal aorta/renal/iliac/femoral arteries

30
Q

Listen for venous hum

A

bell, epigastric/umbilical areas

31
Q

Listen for friction rub

A

over liver and spleen, use diaphragm, over right/left lower rib cage

32
Q

percussion

A

lightly/systematically through all quadrants, determine span and height of liver by determining upper/lower borders - normal decreases after 50, spleen dullness should be noted left 10th rib/slightly posterior to MAL. blunt percussion on liver/kidneys

33
Q

Blunt percussion on liver and kidneys

A

assess for tenderness, over CVA - costovertebral angles

34
Q

palpation

A

light, deep, bladder

35
Q

light palpation

A

abdomen should be non tender/soft

36
Q

deep palpation

A

all four quadrants, detect subtle masses, mild tenderness normal over diploid, aorta, cecum, sigmoid colon, ovaries

37
Q

palpate for

A

masses, umbilicus/surrounding for swelling, bulges, masses, palpate aorta, liver/spleen/kidneys - rarely palpable

38
Q

palpate bladder

A

empty not palpable or tender, distended smooth/round/firm

39
Q

Blumberg sign

A

abdominal pain/tenderness when examiner tests for rebound tenderness - palpate at 90 degrees into abdomen halfway between umbilicus/anterior iliac crest

40
Q

signs

A

psoas, obturator, murphy, rovsing

41
Q

Psoas sign

A

pain in RLQ when leg hyperextended, appendicitis

42
Q

Obturator sign

A

pain in RLQ when hip/knee are flexed, leg rotated internally/externally, irritation of obturator muscles due to appendicitis or perforated appendix

43
Q

Murphy sign

A

pain when pressure applied under liver border at right costal margin and client inhales deeply, inflammation of gallbladder

44
Q

Rovsing sign

A

pain in RLQ during pressure in LLQ, acute appendicitis

Health Assessment (32 decks)

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