Assessing the abdomen Flashcards
Liver Gallbladder Duodenum
Head of pancreas
Right kidney and
adrenal gland
Hepatic flexure of
colon
Part of ascending and
transverse colon
Right Upper Quadrant
Stomach
Spleen
Left lobe of liver Body of pancreas
Left kidney and
adrenal gland
Splenic flexure of
colon
Part of transverse and
descending colon?
LEFT UPPER QUADRANT
Cecum
Appendix
Right ovary and tube
Right ureter Right spermatic cord
Right Lower Quadrant
A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures?
Mesentery
Part of descending
colon
Sigmoid colon
Left ovary and tube
Left ureter Left spermatic cord?
Left Lower Quadrant
A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures. Functions:
o Ingest and digest food
o Absorb nutrients, electrolytes, and water
o Excrete wastes
The Alimentary tract
A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures?
The Peritoneum
Occurs when hollow abdominal organs such as
intestines become distended or contract forcefully or
when the capsule of solid organs such as the liver and
spleen are stretched. Characterized as dull, aching, burning, cramping or colicky?
Visceral Pain
Occurs when the parietal peritoneum becomes inflamed, as in appendicitis or peritonitis characterized as a more
severe and steady pain.?
Parietal Pain
Occurs at distant sites that are innervated at
approximately the same levels as the disrupted
abdominal organ. This kind of pain travels or refers from
the primary site and becomes highly localized at the
distant site?
Referred Pain
Stand on person’s right side and look down on abdomen
Then stoop or sit to gaze across abdomen
Your head should be slightly higher than abdomen
Determine profile from rib margin to pubic bone; contour describes nutritional
state and normally ranges from flat to rounded?
contour
Begin in the ___ and proceed clockwise, covering all quadrants?
RLQ
there is a series of soft click and gurgles are heard at a rate of ___
per minute?
5-30
Hyperactive sounds referred to as ____ may also be heard
indicates/normal sound of the stomach
borborygmus
Reflects diminished motility “ileus“, often follows surgery, viral
illness, severe trauma or overwhelming generalized sepsis, such as
with peritonitis?
HYPOACTIVE bowel sound
Increased bowel sounds may occur with gastroenteritis, early
intestinal obstruction, or hunger. High-pitched tinkling sounds, with rushes and tinkles. Suggest intestinal fluid and air under pressure, as in early
obstruction or phase of ileus resolution?
HYPERACTIVE bowel sound
Referring to an inability to hear any bowel sounds after 5 minutes
of continuous listening, are typically associated with abdominal
pain and rigidity…severe ileus or bowel exhaustion with prolonged
bowel obstruction (indicators of a surgical emergency?
ABSENT bowel sound
What organ is: Place the left hand flat against the lower right anterior rib cage. Use ulnar side
of the right fist to strike the left hand?
LIVER
Percuss the ___ at the costovertebral angles over the 12
the rib?
KIDNEY
PALPATION: Stand at the client’s right side and place you left hand under client’s back at the
level of the 11th to 12th rib?
LIVER
Palpation: Stand at the client’s right-side reach over the abdomen with the left arm and
place the hand under the posterior lower ribs. Pull up gently. Place you right
hand below left costal margin with the fingers pointing towards the client?
spleen
Ask the client to lie on the left side. Hyperextend the right leg of the client. Normally, there is no pain present Abnormal: Pin in the RLQ pain () is associated with irritation of the
iliopsoas muscle due to appendicitis (inflammation of the appendix?**
PSOAS SIGN
Support the client’s right knee and ankle. Flex the hip and knee rotate the leg internally and externally. Normally, there is no presence of abdominal pain
Abnormal: Pain in the RLQ indicates irritation of the obturator muscle due to
appendicitis or a perforated appendix?
obturator sign
PALPATION: Support the right posterior flank with your left hand and
place your right hand in the RUQ just below the costal margin at the MCL?
Kidney
Palpate deeply in the LLQ and quickly release pressure
Normally, there is no rebound pain is elicited
Abnormal: Pain in the RLQ during pressure in the LLQ is a positive Rovsing’s
Sign?
Referred Rebound tenderness
Stroke the abdomen with a sharp object (e.g., broken cotton tipped applicator or
tongue blade) or grasp a fold of skin with your thumb and index finger?
Hypersensitivity test
Assess RUQ pain of tenderness, which may signal cholecystitis (inflammation of
the gallbladder). Press your fingertips under the liver border at the right costal margin and ask
the client to inhale deeply. Normally, there is no increase pain present Abnormal: Accentuated sharp pain that cause the client to hold his or her
breath (inspiratory arrest) is a positive Murphy’s sign and is associate with
acute cholecystitis?
Test for cholecystitis
Hard stools in the colon appear as a
localized distention. Percussion over the
area discloses dullness
feces
The abdomen distended with gas may
appear as a generalized protuberance or
it may appear more localized. Tympany is
the percussion tone over the area?
Flatus
Obesity accounts for most uniformity
protuberant abdomen. The abdominal
wall is thick, and tympany is the
percussion tone elicited. The umbilicus
usually appears sunken
fat
Fluid in the abdomen causes generalized
protuberance, bulging flanks, and an
everted umbilicus. Percussion reveals
dullness over fluid (bottom of the
abdomen and flanks) and tympany over
intestines (top of the abdomen)
ascitic fluid
Results from the bowel protruding
through a weakness in the umbilical
ring. This condition occurs more
frequently in infants, but also occurs in
adults?
UMBILICAL HERNIA
____occurs when the bowel
protrudes through a separation between
the two rectus abdominis muscles. It
appears as a midline ridge. The bulge
may appear only when the client raises
the head or coughs. The condition is of
little significance?
Diastasis Recti
An __ occurs when the
bowel protrudes through a weakness in
the linea alba. The small bulge appears
midline between the xiphoid process and
the umbilicus. It may be discovered only
on palpation?
Epigastric Hernia
(splenomegaly) is
defined by an area of dullness exceeding
7 cm. When enlarged, the spleen
progresses downward and in toward the
midline?
ENLARGED SPLEEN
An
__occurs when the
bowel protrudes through a defect or
weakness resulting from a surgical
incision. It appears as a bulge near a
surgical scar on the abdomenAn incisional hernia occurs when the
bowel protrudes through a defect or
weakness resulting from a surgical
incision. It appears as a bulge near a
surgical scar on the abdomen?
Incisional Hernia
(hepatomegaly) is
defined as a span greater than 12cm at
the mid-clavicular line (MCL) and greater than 8cm at the midsternal liver (MSL). An enlarged nontender liver suggests
congestive heart failure, acute hepatitis, or abscess?
ENLARGED LIVER
An enlarged may be due to cyst, tumor or
hydronephrosis. It may be differentiated
from an enlarged spleen by its smooth
rather than sharp edge, the absence of a
notch, and tympany on percussion?
ENLARGED KIDNEY
An extremely tender, _-___
suggests acute cholecystitis. A positive
finding is Murphy’s sign (sharp pain that
causes the client to hold the breath)?
ENLARGED GALLBLADDER
An enlarged firm, hard, nodular liver
suggests cancer. Other causes may be
late cirrhosis or syPHILIS?
ENLARGED NODULAR LIVER
A prominent laterally pulsating mass
above the umbilicus strongly suggests an
__. It is accompanied by a
bruit and a wide bounding pulse?
AORTIC ANEURYSM
