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Patient Assessment > Chapter 11 The Abdomen > Flashcards

Chapter 11 The Abdomen Flashcards

1
Q

Gastritis/GERD

A

Often occurs with epigastric pain

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2
Q

Cholecystitis

A

Pain in RUQ

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3
Q

IBS (irritable bowel syndrome)

A

Bloating

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4
Q

Aerophagia

A

Belching from swallowing air

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5
Q

GERD

A

primarily sx of heartburn, reflux, regurgitation; aggravated by alcohol, chocolate, onions, coffee, citrus fruits. Some “alarm sx” include dysphagia and odyophagia, vomiting, weight loss, anemia

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6
Q

Renal stone

A

cramping pain radiating to RLQ or LLQ

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7
Q

Caput Medusa

A

Appearance of distended and engorged umbilical veins which are seen radiating from the umbilicus across the abdomen to join systemic veins. Typically associated with cirrhosis and advanced stages of liver disease.

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8
Q

Incisional Hernias

A

Protrusion through an operative scar.

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9
Q

Umbilical Hernias

A

Protrusion through a defective umbilical ring

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10
Q

Direct Inguinal Hernia

A

directly penetrates the inguinal triangle and creates a bulge superior and medial to the inguinal ligament

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11
Q

Indirect Inguinal Hernia

A

passes through the inguinal canal and creates a bulge over the inguinal ligament as it passes through the inguinal ring. In men it often herniates into the scrotum

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12
Q

Diffuse Abdominal distension

A

6Fs: Fat (obesity), Fluid (ascites or obstructed viscera filled with fluid), Flatus (air), Feces (constipation), Fetus (pregnancy), Fatal cancer

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13
Q

Distension of lower abdomen

A

usually caused by pregnancy, full bladder, ovarian tumor, or uterine fibroids (common benign growths)

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14
Q

Visible peristalsis

A

usually abnormal, unless the patient is emaciated. Otherwise, it is a sign of intestinal obstruction.

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15
Q

Borborygmi

A

loud easily audible sound transmitted across the abdomen so it is not necessary to listen at multiple places, commonly called “growling.

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16
Q

Early intestinal obstruction

A

High pitched , tinkling (raindrops in a barrel) sounds

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17
Q

Dull areas of percussion

A

large liver or spleen, distended bladder, pregnant uterus, ovarian tumor

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18
Q

Decreased gut sounds (~1min)

A

can be markedly decreased after abdominal surgery; abdominal infection or injury

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19
Q

Absent gut sounds (~5 min)

A

Can be caused from perforation, infection, infarction, or ischemia

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20
Q

Aortic bruits

A

Heard in epigastrium; may be a sign of AAA.

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21
Q

Renal artery bruits

A

R& L upper quadrants; may be a sign of renal artery stenosis (tx cause of hypertension)

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22
Q

Illiac/femoral bruits

A

R & L lower quadrants; may be a sign of peripheral atherosclerosis

23
Q

Friction rubs

A

scratchy sounds that may indicate possible splenic infarction or hepatic infarction, tumor, or abscess.

24
Q

Tympany

A

hollow sounds; normally present over most of the abdomen in the supine position, caused from bowel gas

25
Q

Enlarged liver

A

Midclavicular percussion >12 cm (normal 6-12 cm)

26
Q

Small liver

A

Mid-sternal percussion <4cm (normal 4-8 cm); can cirrhosis, end stage liver disease

27
Q

Rebound tenderness

A

peritoneal inflammation

28
Q

Tenderness of liver

A

suggests inflammation as in hepatitis

29
Q

Splenomegaly

A

if percussion dullness is present

30
Q

Ascites

A

protuberant abdomen with bulging flanks; from diseases such as cirrhosis and cancer

31
Q

Areas of dullness (ascites)

A

located on lateral side of abdomen

32
Q

Areas of tympany (ascites)

A

anterior portion of abdomen

33
Q

Positive splenic percussion sign

A

change in percussion note from tympany to dullness on inspiration that suggests splenomegaly.

34
Q

Kidney enlargement

A

hydronephrosis, cyts, and tumors

35
Q

Test for shifting dullness (ascites)

A

Have the patient roll to one side. In ascites there should be a shift due to free fluid moving with gravity.

36
Q

Voluntary guarding

A

patient consciously flinches when you touch them

37
Q

Involuntary guarding

A

muscles spasm when you touch them but the patient cannot control the reaction which is a sign of inflammation or tenderness

38
Q

Techniques to asses voluntary guarding

A

Have the patient breathe out deeply, Have the patient mouth breathe with the jaw dropped open

39
Q

Rigidity

A

a constant board-like spasm which is a sign of perforation, peritonitis, or bowel infarction

40
Q

Reducible hernia palpation

A

when the contents of the hernia can be easily displaced

41
Q

Irreducible or incarceratedm hernia palpation

A

when the contents cannot be displaced and are stuck

42
Q

Strangulated hernia palpation

A

an incarcerated hernia that has cut off its blood supply, resulting in tissue necrosis and gangrene.

43
Q

Acute Appendicitis: PE signs

A

RLQ pain (or pain that migrates from periumbilical region) that leades to positive rebound tenderness, Rovsing’s sign, Psoa’s sign, Obturator sign

44
Q

McBurney’s Point

A

In appendicitis, tenderness over right side of abdomen that is one third the distance from the anterior superior iliac spine to the umbilicus

45
Q

Rovsing’s Sign

A

Similiar to rebound tenderness but putting pressure on opposite side of LLQ. In the case of appendicitis, the pain is felt in the right lower quadrant despite pressure being placed elsewhere.

46
Q

Psoa’s sign

A

Pain is elicited on hip extension of right thigh (pt lying on left side). If appendix is inflamed and in contact with the psoas muscle, which when stretched will cause pain

47
Q

Obturator sign

A

Pain on internal rotation of flexed thigh. Inflamed appendix is in contact with the obturator internus muscle, which is stretched in this maneuver.

48
Q

Cholecystitis: PE findings

A

localized or diffuse RUQ pain that may radiate right to scapula, positive murphy’s sign

49
Q

Positive Murphy’s Sign

A

When deep palpation toward the liver at the right costal margin causes severe pain, and possible a palpable mass from an enlarge gallbladder may be noted

50
Q

Pancreatitis: PE findings

A

severe abdominal pain in LUQ and may radiate to left upper back

51
Q

Grey turner’s sign

A

Ecchymoses on the abdomen noted most often in left flank that occurs with acute hemorrhagic pancreatitis

52
Q

Diverticulitis: PE findings

A

Sx can feel like appendicitis; LLQ pain with a palpable mass, pain is severe and comes on suddenly

53
Q

to assess in periumbilical area

A

any mlasses of distended loops of bowl, hepatomegaly, splenomegalo, enlarged kidneys, enlarged gallbladder, pulsatile mass in midline indicating an aortic aneurysm, femoral pulses and inguinal nodes

54
Q

Hepatitis

A

Cirrhosis of the liver (decrease in size)

Patient Assessment (18 decks)

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