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Health Assessment Exam 2 > Chapter 21: Abdomen > Flashcards

Chapter 21: Abdomen Flashcards

1
Q

What are al internal organs in the abdominal cavity called?

A

Viscera

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2
Q

Where is the small intestine located?

A

In all four quadrants

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3
Q

Where is the spleen located

A

ULQ

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4
Q

Where is the liver located?

A

URQ

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5
Q

Where is the stomach primarily located?

A

ULQ

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6
Q

Where is the descending colon primarily located?

A

LUQ

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7
Q

Where is the ascending colon primarily located?

A

RUQ

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8
Q

Where is the pancreas?

A

Mainly in LUQ but also crosses over into RUQ

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9
Q

What are the midline organs?

A

Aorta, Uterus (if enlarged), Bladder (if distended)

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10
Q

Reasons for abdominal pain

A
  • Occurs in acute and chronic conditions

- Can be due to digestive, reproductive disorders or urinary system disorders

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11
Q

Risk factors and considerations for abdominal pains

A
  • Alcohol abuse
  • H-pylori: peptic ulcer
  • Medications
  • Stress
  • Smoking
  • Congenital defects
  • Travel to other countries
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12
Q

When should you be concerned about an umbilical hernia?

A

Bulging of belly button, normal for the first 6 months but should not persist longer. Usually more prominent when baby cries

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13
Q

Diastasis recti

A

separation of the abdominal rectus muscles with visible bulge along midline

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14
Q

Liver size in infant and children

A

Liver takes up proportionately more space in the abdomen at birth than in later in life

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15
Q

Pyloric Stenosis

A

narrowing of the opening of the pylorus causing food to come back up (congenital defect)

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16
Q

Acute gastroenteritis

A

Stomach flu (An intestinal infection marked by diarrhea, cramps, nausea, vomiting, and fever.)

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17
Q

Developmental competence in pregnant women

A

Nausea and vomiting, Production of hCG, Acid indigestion or “heartburn” “pyrosis” because of esophageal reflux, GI motility decreases prolonging gastric emptying leading to more water reabsorption and constipation, Hemorrhoids, Intestines move upward and posteriorly because the uterus is displaced, Striae and linea nigra are present

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18
Q

Developmental competence in aging adults

A

Salivation decreases, Esophageal emptying is delayed, Gastric acid secretion decreases (leading to pernicious anemia , iron deficiency, anemia, calcium malabsorption)

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19
Q

Reason for constipation in aging adults

A

Decreased physical activity, Low fiber diet, side effects of medications, bowel obstruction, hypothyroidism, inadequate toilet facilities

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20
Q

Stool assessments

A
  • Brown/light brown (normal)
  • Dark, tarry stool can indicate upper intestinal bleed
  • Bright red (frank) bleeding can indicate lower intestinal bleeding
  • Clay colored (biliary system)
  • Presence of bright red streaks often indicates hemorrhoids or fissures
  • Constipation
  • Diarrhea (frequency)
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21
Q

Emesis Assessment

A
  • Hematemesis
  • Frank blood (Upper)
  • Blood tinged (Lower)
  • Food particles
  • Bile
  • Coffee ground
  • Posttussive emesis
  • Amount and Frequency
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22
Q

When you’re percussing the abdomen what should it sound like?

A
  • Tympany

- Dull in the upper quadrants, Dull if stool is present

23
Q

Ascites

A

Fluid in abdominal cavity that can cause change in sound

24
Q

Palpation of the abdomen

A

You do not want to deeply palpate, palpate last

  • *Looking for masses
  • *You do not want to feel organs
  • *Do not palpate if the patient is immunocompromised or has mono/epstein barr
25
Q

4 contours of stomach

A

Flat
Rounded
Scaphoid: dip in the middle of the abdomen
Protuberant: Distended at the bottom of the stomach

26
Q

When is Ascites common?

A

Portal hypertension
Cirrhosis
Kidney patients , Liver patients

27
Q

Auscultation of the bowels

A
  • Sounds are irregular, gurgling sounds 5-30x/minute
  • Bowel sounds (How do you describe?)
  • Listen if there are Vascular sounds or Peritoneal friction rub
28
Q

Borborygmus

A

sound of hyperperistalsis

29
Q

What happens if abdomen is perfectly silent?

A

you must listen for 5 minutes by your watch before deciding bowel sounds are completely absent

30
Q

Liver Span assessment

A

Percussing the abdomen to see where the liver border is (dull)
Usually in the 5th intercostal space
Liver usually 10.5 cm for males, 7cm for females

31
Q

Splenic Dullness

A

Often spleen obscured by stomach contents, but you may locate it by percussing for a dull note from 9th to 11th intercostal space just behind left midaxillary line

32
Q

CVA tenderness

A

Assessing for costovertebral angle tenderness (CVA)
Normal: non tender
Tenderness is causes by acute infection (pylonephritis)

33
Q

Ascites sound when percussed

A

Dull

34
Q

Hooking technique

A

An alternative method of palpating liver is to stand up at person’s shoulder and swivel your body to right so that you face person’s feet
Hook your fingers over costal margin from above
-Ask person to take a deep breath
-Try to feel liver edge bump your fingertips

35
Q

Palpation of aorta

A

Using your opposing thumb and fingers, palpate aortic pulsation in upper abdomen slightly to left of midline

36
Q

Rebound tenderness (Blumberg’s sign)

A

Put your hand in the area and pain is felt when the hand is taken off and pressure is no longer put on the spot

37
Q

Rovsing’s sign

A

Pressure on left lower quadrant and the pain is felt on opposite side

38
Q

Inspiratory arrest (Murphys sign)

A

Sign of cholecystitis

39
Q

Psoas test

A

Lift left leg straight up while supine and see if pain is felt in McBurneys point

40
Q

Obturator sign

A

Inflamed appendix when knee is bent and pain is felt

41
Q

Reasons for abdominal distension

A 
Obesity
Air or gas
Ascites
Ovarian cyst
Pregnancy
Feces
Tumor
42
Q

Succussion splash

A

Loud splash auscultated over the upper abdomen when infant is rocked side to side
-Indicates increased air and fluid in the stomach

43
Q

Peristalsis with projectile vomiting in newborn suggests what?

A

Pyloric stenosis

44
Q

Hypoactive bowel sounds

A

Diminished or absent bowel sounds signalling decreased motility as a result of inflammation as seen with peritonitis
Occurs with pneumonia

45
Q

Hyperactive bowel sounds

A

Loud gurgling “borborygmi” signal increased motility that occurs with early mechanical bowel obstruction (high pitched), gastroenteritis, brisk diarrhea, laxative use and subsiding paralytic ileus

46
Q

Peritoneal friction rub

A

rough grating sound like two pieces of leather rubbed together, indicated peritoneal inflammation

47
Q

Liver friction rub location

A

friction rub over lower right rib cage from abscess or metastatic tumor

48
Q

Spleenic friction rub location

A

friction rub over lower left rib cage in left anterior axillary line from abscess, infection or tumor

49
Q

Vascular sounds

A

Arterial – bruit indicates turbulent blood flow as found in constricted, abnormally dilated, or tortuous vessels

50
Q

Aortic aneurysm sound

A

murmur is harsh, systolic, or continuous and accentuated with systole. Note in those with HTN

51
Q

Renal artery stenosis (location and sound)

A

murmur is midline or towards flank, soft, low to medium pitch

52
Q

Venous hum

A

In periumbilical region, originates from inf. vena cave. Medium pitches, continuous sound, Palpable thrill, Occurs with Portal HTN and cirrhotic liver

53
Q

Order of Abdomen Exam

A

Inspect, Auscultate, Percuss, Palpate (lightly)

Health Assessment Exam 2 (7 decks)

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