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Comprehensive Health Assessments > Chapter 13: Abdomen and GI System > Flashcards

Chapter 13: Abdomen and GI System Flashcards

1
Q

Aneurysm

A

A ballooning out or abnormally widening of part of a weakened artery wall

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2
Q

Appendicitis

A

condition in which the appendix becomes inflamed, swollen, or infected

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3
Q

Bruit

A

sounds resembling heart murmurs
- swishing or washing machine-like sounds

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4
Q

Contour

A

smooth outline or shape of the abdomen

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5
Q

Costovertebral Angle

A

90 degree angle formed between the curve of the 12th rib located on the back at the bottom of rib cage and spine

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6
Q

Distention

A

an enlargement, dilation, or ballooning effect of the abdomen

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7
Q

Gastrostomy Tube

A

tube inserted through the abdomen that delivers nutrition directly to the stomach

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8
Q

Iliopsoas

A

two separate abdominal muscles (psoas and iliacus) merged in the thigh

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9
Q

Nasogastric Tube

A

thin tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach to carry food and medicine

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10
Q

Obturator Muscle Test

A

physical test of inflammation in the region of the obturator internus muscle; usual cause is an inflamed appendix

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11
Q

Ostomy

A

a hole made by surgery to allow stool or urine to leave the body through the abdomen

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12
Q

Rebound Tenderness

A

deep palpation over the suspected inflamed appendix followed by sudden release of the pressure which causes the severe pain on the site
- indicates peritonitis (inflamed peritoneal)

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13
Q

Scaphoid

A

condition in which the anterior abdominal wall is sunken and presents a concave rather than a convex contour

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14
Q

Tympany

A

high pitched sound that indicates a hollow space filled by air or gas in the stomach or intestine

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15
Q

Umbilicus

A

belly button

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16
Q

Urinary Catheter

A

a hollow tube inserted into the bladder to drain or collect urine

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17
Q

What is important about the physical examination of the abdomen ?

A

order must be:
- inspection
- auscultation (must follow inspection)
- percussion
- palpation
(percussion and palpation can be flipped)

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18
Q

What are some important things to ensure for a abdominal assessment ?

A
  • client must empty bladder before
  • expose abdomen from xyphoid process to groin
  • position in supine position with pillow under head and knees (if not pillow then have patient bend knees)
  • avoid quick, unexpected movements
  • watch facial expressions during exam
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19
Q

What is ascities and what are the symptoms (interstitial fluid) ?

A

it’s the buildup of fluid in the abdomen that is indicative of liver failure
- abdominal distension
- different from being fat because the belly is firm/hard

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20
Q

How do you measure abdominal distension ?

A

measuring tape around abdomen at the level of the superior iliac crests

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21
Q

What side of stethoscope do you use to listen for bowel sounds ?

A

diaphragm
- bell is for bruits

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22
Q

What are normal bowel sounds ?

A

high-pitched gurgling or clicking sounds
- usually occur 5 to 35 times per min

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23
Q

What types of sounds aren’t normal in the abdomen ?

A

vascular sounds

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24
Q

What are some reasons for abdominal distension ?

A
  • obesity (fat)
  • air or gas (flatulence)
  • ascites (interstitial fluid)
  • cyst or abscess (ovarian or intra-abdominal)
  • pregnancy
  • feces (constipation/fecal impaction)
  • tumor (uterine fibroid, colon or other GI cancer, benign or malignant)
  • hernia (bowel pushing through abdominal wall musculature)
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25
Q

What is the sequence you take to auscultate the bowel sounds ?

A

RUQ, LUQ, LLQ, RLQ

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26
Q

What are normoactive bowel sounds ?

A
  • irregular
  • high pitched gurgles or clicks (5-35 times per min)
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27
Q

What are hypoactive bowel sounds ?

A
  • 1-4 sounds per min
  • lower in pitch
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28
Q

What are hyperactive bowel sounds ?

A
  • more than 35 sounds per min
  • high-pitched sounds
  • borborygmi (rumbling or gurgling sounds)
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29
Q

What are some reasons for hypoactive bowel sounds ?

A
  • bowel/mechanical obstruction
  • NPO (nothing per mouth)
  • haven’t eaten anything in a while
  • paralytic (paralysis)
30
Q

What are some reasons for hyperactive bowel sounds ?

A
  • diarrhea
  • stomach bug
  • Crohn’s
31
Q

What are arterial vascular sounds ?

A
  • heard in 4-20% of healthy people
  • during systole
  • continuous regardless of patient position
  • swishing sound
  • use bell of stethoscope over aorta, renal, iliac, and femoral arteries for bruits
32
Q

What are venous vascular sounds ?

A
  • soft sound
  • continuous, louder diastolic component
  • low pitched
  • use bell of stethoscope over epigastric region and around umbilicus
  • can be heard in some young, healthy individuals
  • associated with portal hypertension & cirrhosis
33
Q

How much should you depress for palpation ?

A
  • about 1 cm
34
Q

What are some organs you shouldn’t be able to palpate ?

A

kidneys, spleen, or gallbladder

35
Q

When should you palpate the areas of reported pain ?

A

palpate these last
- it could cause them to tense up which could affect your findings
- observe for facial grimaces

36
Q

When is percussion done ?

A

when you suspect distension, fluid or solid masses

37
Q

When percussing where do you strike your finger ?

A

use indirect finger for percussion
- strike between cuticle and first joint (distal interphalangeal joint)

38
Q

What are some signs/symptoms of visceral pain ?

A

arises from abdominal organ
- dull pain, poorly localized (intestinal obstruction, pancreatic tumor)
- can’t really locate where pain is

39
Q

What are some signs/symptoms of parietal (somatic) pain ?

A

caused by inflammation of structure
- pain is sharp and well localized (peritonitis, ruptured appendix)

40
Q

What is McBurney Point ?

A

point of specialized tenderness in acute appendicitis between the umbilicus and the right anterior superior iliac spine

41
Q

What is a test that means acute appendicitis ?

A
  • rebound tenderness: press firmly into the abdomen and release quickly which will cause pain (pain is felt when pressure is released and not when pressure is applied)
  • pain= acute appendicitis
  • worse when they cough
42
Q

What is the iliopsoas muscle test ?

A

assessment for pain caused by inflammation
- performed if appendicitis is suspected
- press against raised, right leg or place patient on left side and have patient hyperextend the right leg at the hip
- iliopsoas muscle may be irritated indicating inflamed appendix

43
Q

What is the obturator muscle test ?

A

assessment for pain caused by inflammation
- performed if ruptured appendix or pelvic abscess is suspected
- raise the patient’s right leg with the knee flexed
- pain in hypogastric region indicated irritation to obturator muscle

44
Q

What is incontinence ?

A

lack of control of urination or defecation

45
Q

What is stress incontinence ?

A

loss of urine (small) during physical experience, laughing, sneezing, exercising

46
Q

What is urge incontinence ?

A

strong, sudden urge to void
- comes on really fast
- associated with diabetes, Parkinson’s, multiple sclerosis, stroke

47
Q

What is overflow incontinence ?

A

when the bladder is already full and there is leaking of urine from the bladder
- associated with enlarged prostate

48
Q

What is functional incontinence ?

A

don’t have any problems with bladder but can’t get to the bathroom quickly enough
- associated with mobility issues, like arthritis

49
Q

What does dark urine signify?

A

kidney or liver disease

50
Q

What are some pediatric consideration for newborns ?

A
  • synchronous abdominal and chest wall movements
  • diastasis rectus during crying
  • visible pulsations (epigastric) are common
  • edge of liver may be palpable (1-2 cm below right costal margin)
  • both kidneys may be noted with deep palpation
51
Q

What are some pediatric consideration for toddlers/children ?

A
  • round (bot) belly present
  • umbilical hernia can be present (most resolve spontaneously)
  • belly breathers until age 7
52
Q

What is expected palpation results ?

A
  • no tenderness
  • relaxed muscles throughout
  • no masses
53
Q

What is a common reason for tympany ?

A
  • gas
54
Q

What are common reasons for dullness ?

A
  • distension
  • fluid
  • mass
  • liver
  • spleen (normally can’t be percussed)
  • full stomach and stool may create dullness
55
Q

What organs are found in the RUQ ?

A
  • liver
  • gallbladder
  • duodenum
56
Q

What organs are found in the LUQ ?

A
  • spleen
  • stomach
  • heart
57
Q

What organs are found in the RLQ ?

A
  • cecum
  • appendix
58
Q

What organs are found in the LLQ ?

A
  • sigmoid colon
59
Q

What are some symptoms of a bladder infection ?

A

pain or burning with urination

60
Q

What can frequent urinating in small amounts mean ?

A
  • infection
  • incontinence
  • enlarged prostate
61
Q

What are some symptoms of kidney infection (pyelonephritis) or kidney stone ?

A

fever, chills, and backpain

62
Q

What can edema and low urine output mean ?

A

kidney failure causing fluid retention
- SOB, sudden weight gain

63
Q

What are some normal inspection findings ?

A
  • abdomen flat or rounded and symmetrical
  • uniform in color and pigmentation
  • striae, scars, faint vascular network may be present
  • surface is smooth, with centrally located umbilicus
  • no masses or nodules
  • ripples of peristalsis not usually visible
  • non-exaggerated pulsation of the abdominal aorta may be present
  • no respiratory retractions
64
Q

What is cirrhosis ?

A

degenerative disease that causes scarring and liver failure

65
Q

What is Gastroesophageal Reflex Disease (GERD) ?

A

chronic digestive disease where the liquid content (acid and enzymes) of the stomach refluxes to the esophagus

66
Q

How long do you listen to the bowel sounds before determining if they are absent ?

A

a total of 4 minutes
- 1 min in each quadrant

67
Q

With what side of the stethoscope do you listen for bowel sounds ?

A

with the diaphragm
- bell is used for bruits

68
Q

What is the order of quadrants when auscultating for bowel sounds ?

A

RUQ, LUQ, LLQ, RLQ

69
Q

What is the range for normoactive bowel sounds ?

A

5-30 per min

70
Q

What does dark urine usually mean ?

A

kidney or liver disease

Comprehensive Health Assessments (13 decks)

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