Chapter 22/12: The Abdomen and Nutrition Flashcards
lina alba
- tendinous seam that joins the abdominal muscles
rectus abdominis
forms a strip extending the length of the midline, its edge is more palpable
viscera
all the internal organs
solid viscera
those that maintain a characteristic shape
Examples: liver, pancreas, spleen, adrenal glands, kidneys, overies, and uterus
hollow visera examples
stomach, gallbladder, small intestine, colon, bladder
what forms the costovertebral angle
12th rib and the vertebral column
lactose intolerance
inidividual have a lower level of lactase
gastrointestinal ulcers are cuased by
- H. pylori
- NSIADS
- alcohol
- smoking
anorexia
loss of appetite that occurs with GI disease, is an adverse effect of some medications, occurs with pregnancy, or psychological disorders, cancer
dysphagia occurs with
disorders of the throat or esophagus (cancer)
pyrosis
heartburn
viseral pain is described as
dull, general, poorly localized
parietal pain is described as
sharp, precisely localized, aggravated by movement
hematemesis
blood in vomit
hematemesis occurs with
stomach or douodenal ulcers
abdoninal adheasions
scar tissue in abdomen
- from previous abdominal infection or surgery
- can cause: pain, nausea, vomiting, cramping, constipation, bloating, or complete bowel obstruction
anorexia nervosa
serious phychosocial disorder that include loss of appitite, voluntary starvation, and grave weight loss
hernia
protrusion of the abdominal visera through abnormal opening in the muscle wall
glistering and tautness of the skin
with ascites
ecchymoses
brusising
red bruise
new bruise
blue black or purple bruise
1-4 days old
yellow green or brown bruise
5 or more days
striae
silvery, white linear, jagged marks approximently 1-6 cm long
- “stretch marks”
striae loom purple blud in patients with
crushing syndrome
cutaneous angiomas occur with
portal hypertension or liver disease
hyperactive sounds
- lous high pitched, rushing, tinking sound signaling increased motility
- may indicate bowel obstruction
hypoactive / absent sounds
- after abdominal surgery or with inflammation of the peritoneum
voluntary gaurding
when the patient is, cold, tense or tickelish
the scratch test is used to
define the liver border when the abdomen is distended or the abdominal muscles are tense
what should be the order of objective assesment of the abdomen
- inspection
- ausclation
- percussion
- palpation
solid viscera examples
- liver
- spleen
- kidneys
- pancreas
- adrenal glands
- ovaries
hallow visera examples
- stomach
- gullbladder
- small intestine
- colon
- bladder
urgent pain examples
- appendicitis, cholecystitis, bowel obstruction, perforation
chronic pain examples
gastric ulcers (empty stomach); doudenal ulcers (2 to 3 hours post prandial, relieved with food intake )
black tarry stool is indicative of
occult blood (melena) from goastrointerstiial bleeding
black non tarry stool is indicative of
iron supplements
grey stool is indicative of
hepatitis
what are the possible systems of colorectal cancer
- narrower than usual, blood, diarrhea, constipation
what is the sequence in which the abdomen should be assessed
- inspection
- auscltation
- percussion
- palpation
absolute stiffness during abdominal inspection is indicative of
peritonitis
what is the normal amount of bowel sounds
5-30 per minute
hypoactive bowel sounds
- diminished, absent
- decreased motility
- inflammation (peritonitis)
- paralytic ileus (post operative bowel surgery)
hyperactive bowel sounds
- loud, gurgling (borborygami)
- increased motility
- early mechanical bowel obstruction (high pitched)
- gastroenterititis
- diarrhea
- laxatives
friction rub
- rough grating sound (leather rubbing)
- peritoneal (inflammation): liver and spleen (infection, tumors)
venous hum
- periumbilical (portal hypertension, liver cirrhosis)
vascular sounds should be listen to with what part of the stethoscope
bell
what quadrant should you start listening to during abdominal ausculations
RLQ
tympany percussion sounds
- air in alimentary canal
dull percussion sounds
- solid organs (liver, spleen)
- fluid
- full bladder
flat percussion sounds
- bones
how big is the liver in men
10.5
how big is the liver in women
- 7cm
Costovertebral angle (CVA) tenderness unexpected finding
sharp pain (kidney inflammation)
developmental considerations for older adults
- redistribution of adipose tissue
- decreased salvations (oral dryness, decreased taste sensation)
- delayed esophageal emptying (aspiration risk)
- decreased gastric acid secretions
- dehydration
- liver size decreases with age (medications)
- renal function decreases (medication)
- delayed esophageal emptying (aspiration risk)
- constipation (decreased motility, dietary habits, medications)
- colorectal cancer increases
what is included in the nutritional assessment
- eating pattern
- usual weight, recent weight changes
- changes in appetite, taste, smell, chewing, swallowing
- recent surgery, trauma, burns, infection
- chronic conditions
- nausea, vomiting, diarrhea, constipation
- food allergies or intolerances
- medications, nutritional supplements, herbal supplements
- self management behaviours; acess to healthy foods
formula for percent usual body weight
current weight/ usual weight X 100
hemoglobin high
dehydration
hemoglobin low
anemia
serum albumin
- decreased with protein deficiency
serum tranferrin
- decreased with protein deficency
prealbumin elevated
renal disease
prealbumin decreased
protein depletion (burns, trauma, surgery)
nitrogen balance
protien status
children should eat ful fat milk up to what age
2 years old
developmetal considerations for adolescents
- increased energy and proetin requirements
- oncreased calcium and iron requirements (in females)
risks for undernutrition
- poor physical or mental health, social isolation, limited functional ability, poverty, polypharmacy
normal physiological changes of aging
- poor dentition, decreased visual acuity, decreased saliva production, slowed GI motility, decreased absorption, and diminished olfactory and taste sensitivity
