Chapter 11: Abdomen Flashcards
Anatomy
Rectus abdominis
umbilicus
midline: overlying linea alba
Identifying locations
RUQ, LUQ, RLQ, LLQ
Epigastric, umbilical, suprapubic
RUQ structures
liver, gallbladder, lower pole rt kidney
LUQ
spleen, pancreas
LLQ
tubular colon
RLQ
bowel, appendix
RUQ or epigastric pain
Biliary tree, liver
epigastric pain
stomach, duodenum, pancreas
periumbilical pain
small intestine, appendix, proximal colon
suprapubic, sacral pain
rectum
hypogastric pain
colon, bladder, uterus
ureteral pain
referred down inner thigh into testes
sequence of exam
inspection, auscultation, percussion, palpation
bruits
renal, aorta, iliac, femoral
rebound tenderness
peritoneal inflammation
pleurisy
abd pain and tenderness r/f pleural inflammation-when unilateral may mimic cholecystitis or appendicitis
acute salpingitis
freq bilateral, tenderness (inflammation of fallopian tubes) usu max above the inguinal ligaments. +rebound tenderness and rigidity. pelvic-motion of uterus causes pain
rosving’s sign
Press deeply and evenly in LLQ then withdraw. pain in rlq during left sided pressure suggests appendicitis
psoas sign
Place your hand above the pt right knee. ask pt to raise that thigh against hand.
pain from irritation of the psoas muscle suggests inflamed appendix
obturator sign
FLEX THE PT RIGHT THIGH AT HIP, with the knee bent, and rotate the leg internally at the hip-stretches the internal obturator muscle.
right hypogastric pain in a positive obturator sign-inflamed appendix
murphy’s sign
hook thumb under the right costal margin at edge of the rectus muscle and ask patient to take a deep breath. sharp tenderness and a sudden stop in inspiratory effort +murphy’s sign
