CH: 22 Abdomen Flashcards
assessment order for abdomen?
inspect
auscultate
percuss
palpate
which organs are in the solid viscera?
liver
pancreas
spleen
adrenal glands
kidneys
ovaries
uterus
what organs are in the hollow viscera?
stomach
gallbladder
small intestine
colon
bladder
what does the hollow viscera shape depend on?
contents
how many quadrants in the abdomen?
4
which quadrant do you start assessment in?
the right lower quadrant
what direction do you assess the abdomen in?
clockwise
why is the abdomen assessment sequence different?
to not disrupt abdominal contents
what are the regions of the abdomen?
epigastric
umbilical
suprapubic
organs in RLQ?
appendix
ascending colon
which organs in RUQ?
liver
gallbladder
organs in LLQ?
descending colon
sigmoid colon
organs in LUQ?
stomach
spleen
small intestine
watery stool is?
diarrhea
which kidney is lower than the other?
right kidney due to liver
what labs tell us about protein?
liver panel:
total protein and albumin
what do you do with stethoscope before auscultating?
warm! and press lightly
____ accumulation is common in aging adults
fat
why is decreased saliva important?
saliva breaks down food and impairs taste buds
*could increase sugar or salt intake
*important in diabetes, heart failure, hypertension
why is delayed esophageal emptying important?
increases aspiration risk and sphincter issues (acid reflux or aspiration)
*stays in esophagus longer
what is important with pernicious anemia?
B12
why is impaired calcium absorption problematic?
we steal it from bones
*can develop osteoporosis
_____ in liver size in older adults?
decrease
*can cause impaired metabolism of meds and toxins - can develop serious side effects (may need to decrease doses, can cause liver and kidney problems)
big thing about any assessment?
not exposing patient
only lift gown when ready to examine
what could pulsations in the abdomen indicate?
abdominal aortic aneurysm
scaphoid contour?
concaved/sunken in
protuberant contour?
protruding outward
*may see in ascites, obesity, pregnancy
what are the different hernias?
hiatal - stomach
umbilical - umbilicus (usually in belly button/intestine)
scrotal - genitalia
what side of stethoscope for vascular sounds?
the bell (low, soft pitched sounds)
which side of stethoscope better for bowel sounds?
diaphragm (high pitched)
what are hypoactive bowel sounds?
decreased, can follow surgery or inflammation
*<5 per min
what are hyperactive bowel sounds?
loud, high pitched- signal increased motility
*>30 per min
normal bowel sounds?
irregular
cascading
high pitched
gurgling
5-30 per min
what pattern do you follow for percussing the abdomen?
zigzag pattern
*bc the way intestines flow
how many times to strike finger during percussion?
twice
what sound do you hear when percussing over abdomen?
tympany
*bc air filled areas like intestines
dull sound when?
over organs
flat sound when?
over bone
what is a fluid wave test?
for ascites
*pt places hand over umbilicus and you push fluid from one side- if you feel wave on other side its positive
what types of patients develop ascites?
liver issues
kidney issues (fluid overload)
heart failure
cancer
_______ organs are abnormal during palpation
enlarged
______ palpation followed by ______ palpation
light, deep
assess painful/tender areas when?
last
for liver palpation place hands where?
pt back between 11 and 12 rib and push up and hand on front midclavicular
*have pt breath slowly
what is rebound tenderness?
more pain when pressure to area is released
*usually present in peritonitis
what is blumberg’s sign associated with?
appendicitis
what is murphy’s sign associated with?
cholecystitis (gall bladder issues)
should you push on enlargements?
no
costovertebral tenderness?
tapping over flank (kidney) to see if tender
*usually with renal inflammation or stones or UTI
best position for abdominal assessment?
supine and flat
where would you notice pulsations/movements?
below xiphoid process
where do you auscultate the abdominal aorta?
midline
under xiphoid above belly button
where do you auscultate renal arteries?
above belly button laterally
where do you auscultate the iliac arteries?
below belly button laterally
what is normal when listening for vascular sounds?
to hear nothing
*bruit= abnormal (stenosis)
which enlarged organs would you feel with light palpations?
liver and nodules
which enlarged organs would you feel with deep palpations?
spleen
kidney
where do you feel an umbilical hernia?
usually in belly button/intestine
have pt cough
where do you feel epigastric hernia?
epigastric area
palpable when pt stands
where do you feel incisional hernia?
anywhere there is an incision
seen when sitting or standing
