ch 22 Jarvis Abdomen Flashcards
Tympany, hyperresonance, and dullness
abdominal assessment (normal findings)
notes normally heard during the abdominal assessment may include tympany, which should predominate because air in the intestines rises to the surface when the person is supine
Percussion (sound in abdomen)
which may be present with gaseous distention
hyperresonance
which may be found over a distended bladder, adipose tissue, fluid, or a mass.
dullness
Gastric acid secretion decreases with aging causing condition.because it interferes with vitamin B12 absorption, iron-deficiency anemia, and malabsorption of calcium.
pernicious anemia
inflammation of the kidney or paranephric area.
costovertebral angles
is free fluid in the peritoneal cavity
-occurs with heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and cancer..
Ascites
may be tarry as a result of occult blood (melena) from gastrointestinal bleeding
Black stools
occurs with localized bleeding around the anus.
Red blood in stools
iliopsoas muscle is inflamed
appendix (RLQ)
musculature is thinner and has less tone than that of the younger adult
- abdominal rigidity with an acute abdominal condition is less common in the aging person.
- The older adult with an acute abdominal condition often complains less about pain than the younger person.
older adult, the abdominal findings
Significant peristalsis, together with projectile vomiting, in the newborn
- After feeding, pronounced peristaltic waves cross from left to right, leading to projectile vomiting.
- One can also palpate an olive-sized mass in the right upper quadrant.
pyloric stenosis in infant
- palpable during routine examination and feel like a pulsating mass.
- A bruit will be audible
- femoral pulses are present but decreased
- aneurysms are located in the upper abdomen just to the left of midline.
aortic aneurysms
palpating the liver causes no pain.
- In a person with inflammation of the gallbladder, or cholecystitis, pain occurs as the descending liver pushes the inflamed gallbladder onto the examining hand during inspiration .
- The person feels sharp pain and abruptly stops midway during inspiration.
Murphy test
- is white
- contains two umbilical arteries and one vein inside the Wharton jelly.
- The umbilical stump dries within a week, hardens, and falls off in 10 to 14 days.
- Skin will cover the area in 3 to 4 weeks.
At birth, the umbilical cord
is a protrusion of the abdominal viscera through an abnormal opening in the muscle wall..
hernia
with the frequent use of nonsteroidal antiinflammatory drugs,
- alcohol use,
- smoking
- Helicobacter pylori infection.
Peptic ulcer disease occurs with
the mass is enlarged and everted
umbilical hernia
If ascites (fluid in the abdomen) is present, then the examiner will feel a fluid wave when assessing the abdomen
positive fluid wave test
Pain occurs 2 to 3 hours after a meal
- may relieved by more food
duodenal ulcers
Chronic pain usually occurs on an empty stomach.
gastric ulcers
Severe, acute pain would occur with
appendicitis and cholecystitis.
rebound tenderness ex appendix
Testing for the Blumberg sign
should be used when assessing for appendicitis
iliopsoas muscle test