Ch 21 Abdomen Flashcards
Defect or sac formed by dilation in artery wall due to athersclerosis, trauma, or congenital defect
Aneurysm
Loss of appetite for food
Anorexia
Abnormal accumulation of serous fluid within the peritoneal cavity, associated with congestive heart failure, cirrhosis, cancer, or portal hypertension
Ascites
Loud, gurgling bowel sounds signaling increased motility or hyperperistalsis, occurs with early bowel obstruction, gastroenteritis, diarrhea
Borborygmi
Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded
Bruit
First or proximal part of large intestine
Cecum
Inflammation of the gall bladder
Cholecystitis
Lower border of rib margin formed by the medial edges of the 8th, 9th, and 10th ribs
Costal margins
Angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney
Costovertebral angle (CVA)
Midline longitudinal ridge in the abdomen, a separation of abdominal rectus muscles
Diastasis recti
Difficulty swallowing
Dysphagia
Name of abdominal region between costal margins
Epigastrium
Abnormal enlargement of the liver
Hepatomegaly
Abnormal protrusion of bowel through weakening in abdominal musculature
Hernia
Ligament extending from pubic bone to anterior superior iliac spine, forming lower border of abdomen
Inguinal ligament
Midline tendinous seam joining the abdominal muscles
Linea alba
Complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction
Paralytic ileus
Rough grating sound heard through the stethoscope over the site of peritoneal inflammation
Peritoneal friction rub
Inflammation of peritoneum
Peritonitis
Congenital narrowing of pyloric sphincter, forming outflow obstruction of stomach
Pyloric stenosis
Burning sensation in upper abdomen due to reflux of gastric acid (heart burn)
Pyrosis
Midline abdominal muscles extending from rib cage to pubic bone
Rectus abdominus muscles
Abnormally sunken abdominal wall as with malnutrition or underweight
Scaphoid
Abnormal enlargement of the spleen
Splenomegaly
Silvery white or pink scar tissue formed by stretching of abdominal skin as with pregnancy or obesity (lineae albicantes)
Striae
Name of abdominal region just superior to pubic bone
Suprapubic
High pitched, musical, drumlike, hallow percussion note heard when percussing over the stomach and intestine
Tympany
Depression on the abdomen marking site of entry of umbilical cord
Umbilicus
Internal organs
Viscera
What are the solid internal organs
Liver
Pancreas
Spleen
What are the hallow internal organs
GI tract Stomach Intestines Colon Gallbladder Bladder
Name the organs of the RUQ
Liver Gallbladder Head of pancreas Right kidney and adrenal gland Ascending colon
Name the organs in the LUQ
Stomach Spleen Left lobe of liver Body of pancreas Left kidney and adrenal gland Descending colon
Name the organs in the RLQ
Appendix
Cecum
Right ureter, ovary, spermatic cord, and tube
Name the organs in the LLQ
Descending colon
Sigmoid colon
Left ureter, ovary, spermatic cord, and tube
What structures are midline of the abdomen
Aorta
Uterus if enlarged
Bladder if distended
What are the effects of aging
Dry mouth and decrease in saliva
Gets harder to swallow (dysphagia)
Less stomach acid so everything works slower
More gallstones
Decreased liver size making it harder to break down meds
Constipation from decreased activity, fiber, and water
Fat moves to hips and abdomen
This is increased in blacks, American Indians, Asians, and Mediterranean groups
Lactose intolerance
What subjective data should you collect
Appetite
Dysphagia –> might have trouble swallowing pills
Food intolerance
Abdominal pain –> where and better or worse after eating
This pain in the organ is dull and hard to locate so they will say pain is all over the abdomen
Visceral
This pain is sharp and they will be able to tell you exactly where it is
Parietal
What information should you be sure to get in an abdominal history
Good menstrual history with females Any stress that could be causing the pain Bowel habits Rectal bleeding Frequent urination Past abdominal diseases Past abdominal surgeries Medications Nutrition assessment
How should you prepare for an abdominal examination
Good lighting Draping for privacy Be sure to have short nails so you dont tear their skin Promote abdominal relaxation by: -warming hands and stethoscope -comfy -have them breath through their mouth -palpate tender/painful areas last
You see this contour of stomach in people who are smaller or older adults who are thin
Scaphoid
You see this contour of stomach in pregnant women or people with a large build up of gas
Protuberant
What are the 4 contours of the abdomen
Flat
Rounded
Scaphoid
Protuberant
When examining the abdomen lift the gown and be sure to inspect..
Symmetry
The shape of the umbilicus: rounded could mean hernia
Pulsations
Hair
Demeanor (facial expressions)
Check for tubes, ostomies, and scars that could indicate surgery
What are the 8 F’s of abdominal distention (reasons for distention)
- Fat
- Feces back up
- Fibroids (tumors in the female uterus)
- Flatus
- Fluid (ascites: fluid over abd. cavity)
- Fetus (pregnancy)
- False pregnancy (mimics pregnancy)
- Fatal tumor
How should you auscultate for bowel sounds
Listen in all 4 quadrants
Should hear high pitched gurgling
5-30 gurgles/min is normal
When might bowels be more hyperactive
After eating
Growling when you are hungry or before diarrhea
Borborygmus
Anything less than 5 growls per min indicates
Hypoactive bowel sounds
How should you determine if bowel sounds are absent
Listen for 5 whole minutes in each quadrant
If nothing is heart after 20 min total this is an EMERGENCY
Heard over solid organs and masses
Dullness
The average span of the liver is..
6-12 cm
How do you check for costovertebral angle (CVA) tenderness
Percuss the 12th rib on the vertebral column with your non-dominant hand
If there is sharp pain it indicates kidney inflammation
To use light palpation how many cm should you press down
1 cm in small circular motions
To use deep palpation how many cm should you press
5-8 cm (2-3”)
What should you look at when describing masses
Where How big Shape Consistency Mobile Pulsing Tender
Where do you palpate the aorta and how big is it
Left of midclavicular line in LUQ
2.5 - 4 cm
The point where the appendix is located where you want to palpate for suspected appendicitis
McBurney’s point
Where gallbladder or liver inflammation will be, when lungs expand during a deep breath pt will experience pain here
Murphy’s sign
Peritoneal irritation or peritonitis, inflamed appendix and rebound tenderness are usually found here together
Blumberg’s sign
What is pain in the RLQ when you press on the RUQ
Rovsing sign
What is the test called when you raise the leg up flexing at the hip and if you press on the thigh then appendicitis
Iliopsoas muscle test
What abnormal findings might you find when examining the abdomen
Distention
Sounds
Enlarged organs (if you can easily palpate then its probably enlarged)
