Ch 22 Abdomen

Question 1

The spleen lies parallel to the ____ rib, lateral to ____ line
normally measures ___ cm

Answer 1

tenth rib, midaxillary line

normally measures 7 cm

Question 2

costovertebral angle is at the ___ rib

Answer 2

12th

Question 3

gastric ulcers cause pain with ______

Answer 3

empty stomach

Question 4

duodenal ulcers cause pain _____ (timing), relieved with _____

Answer 4

pain 2-3 hours after eating

relieved with more food

Question 5

smoking is risk factor for which GI cancers?

Answer 5

esophageal, stomach, pancreatic

Question 6

silent abdomen is confirmed by listening for ___ min

Answer 6

five

Question 7

Percuss for liver span at ____ line

normal liver span ____ cm

Answer 7

midclavicular

normal span: 6-12 cm

Question 8

Percuss for spleen at ____ line, followed by ____ line (listen for _____ with inspiration)
normal spleen ___ cm

Answer 8

midaxillary first, then percuss in anterior axillary line (listen for tympany with inspiration)
normal span 7 cm

Question 9

Deep abdo palpation: push down ___ cm

Answer 9

5-8 cm

Question 10

Liver palpable > ____ cm past costal margin is enlarged

Answer 10

1-2 cm

Question 11

Aortic pulsation: normally ___ cm wide and pulsates in ___ direction

Answer 11

2.5-4 cm wide

anterior direction

Question 12

Describe how to do Murphy’s sign

-what does it test for?

Answer 12

Palpate under R costal margin, push down
ask patient to inhale
normal = full deep breath without pain
abnormal = stops inspiration halfway when descending liver pushes inflamed gallbladder onto hand
tests for cholecystitis

Question 13

Percussion of ascites will yield what sounds?

Answer 13

tympany at top (air from intestines)

dullness at sides (fluid settles)

Question 14

What are the 7 F’s of common causes of abdo distention?

Answer 14

fat
flatus
fluid
fetus
feces
fetal growth
fibroid

Question 15

Bowel sounds are _____ in early obstruction, _____ in late obstruction

Answer 15

hyperactive (early)

hypoactive or absent (late)

Question 16

Cholecystitis:

• sudden pain in ____ (location) that radiates to ____
• worse with ______
• accompanied by_____
• positive ____ sign

Answer 16

RUQ pain, radiates to R/L scapula
worse with fatty foods, ETOH, caffeine
nausea and vomiting
Murphy’s sign

Question 17

Perforated ulcer can have referred pain to _____

Answer 17

shoulders

Question 18

Pancreatitis has acute midepigastric pain radiating to ____ and sometimes ______

Answer 18

back, sometimes to L scapula or flank

Question 19

Is an enlarged spleen tender?

Answer 19

not usually

tender only if peritoneum is inflamed

Question 20

Critical finding:
-if you hear bruit, do not _____

AAA: will hear _____ pulse

Answer 20

palpate

AAA: femoral pulse present but decreased