Chapter 22 Flashcards
Aneurysm
Defect or sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect
Anorexia
Loss of appetite
Ascites
Abnormal accumulation of serous fluid within the peritoneal cavity associated with heart failure, cirrhosis, cancer, or portal hypertension
Borborygmi
Loud, gurgling bowel sounds signaling increased motility or hyperperistalsis; occurs with early bowel obstruction, gastroenteritis, diarrhea
Bruit
Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded
Cecum
First proximal part of the large intestine
Cholecystitis
Inflammation of the gallbladder
Costal margin
Lower border of the rib margin formed by the medial edges of the 8, 9, and 10th ribs
Costovertebral angle (CVA)
Angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney
Diastasis recti
Midline longitudinal ridge in the abdomen, a separation of abdominal rectus muscles
Dysphagia
Difficulty swallowing
Epigastrium
Name of abdominal region between the costal margins
Hepatomegaly
Abnormal enlargement of the liver
Hernia
Abnormal protrusion of bowel through weakening in abdominal musculature
Inguinal ligament
Ligament extending from pubic bone to anterior superior iliac spine, forming lower border of abdomen
Linea alba
Midline tendinous seam joining the abdominal muscles
Paralytic ileus
Complete absences of peristaltic movement that may follow abdominal surgery or complete bowel obstruction
Peritoneal friction rub
Rough grating sound heard through the stethoscope over the site of peritoneal inflammation
Peritoneum
Double envelope of serous membrane that lines the abdominal wall and covers the surface of most abdominal organs
Peritonitis
Inflammation of the peritoneum
Pyloric stenosis
Congenital narrowing of the pyloric sphincter, forming outflow obstruction of stomach
Pyrosis
Heartburn; Burning sensation of upper abdomen due to reflux of gastric acid
Rectus Abdominis muscles
Midline abdominal muscles extending from rib cage to pubic bone
Scaphoid
Abnormally sunken abdominal wall, as with malnutrition or underweight
Striae
Silvery white/pink scar tissue formed by stretching of abdominal skin as with pregnancy/obesity
Suprapubic
Name of abdominal region just superior to pubic bone
Tympany
High-pitched, musical drum-like percussion note heard when percussing over the stomach and intestine
Umbilicus
Depression on the abdomen marking site of entry of umbilical cord
Viscera
Internal organs
Why do you auscultate before palpate and percuss the abdomen?
Palpation and percussion can increase peristalsis and give you inaccurate normal bowel sounds for that patient.
If there are absent bowel sounds what should you do next?
Listen for 5 minutes
4 conditions that may alter percussion notes heard over the abdomen
Obesity
Air/gas
Ascites
Ovarian cysts
Rigidity
When abdominal muscles do not relax after exhalation
Voluntary guarding
Occurs when a person is cold, tense, or ticklish
Visceral pain
Pain from an internal organ
Dull, general, poorly localized
Somatic pain
Pain from the inflammation of the overlying peritoneum
Sharp, precisely localized, aggravated by movement
Solid viscera
Those that maintain a characteristic shape
Liver, Pancreas, Spleen, adrenal glands, Kidney, ovaries, Uterus
Hollow viscera
Depends of contents
Stomach, gallbladder, small intestine, colon, and bladder
Which organ is located in all 4 quadrants
Small intestine
Which organ is located behind the stomach
Pancreas
Where does the kidney lie?
The 11th and 12th ribs
What is the difference in the left and right kidney?
The right kidney lies lower than the left kidney because of the liver
What is the cause of “morning sickness” in pregnant women?
Change in hormones
Changes in the abdomen because of pregnancy:
Constipation
Hemorrhoids
Displacement of intestine
Diminished bowel sounds
Changes in the abdomen because of age:
Salvation decrease Decrease taste Gastric acid secretion decrease (may lead to pernicious anemia) Increase incidents of gallstones Liver size decrease Drug metabolism by liver decrease Frequent constipation
Symptoms of lactose intolerance
Abdominal pain
Bloating
Flatulence
Anorexia
The loss of appetite from GI disease (due to medication), pregnancy, or mental health disorder
Important question to ask when assessing abdomen:
Bowel habits
GI problems
Abdominal surgery
Medications currently taking
What color would striae be with a person with Cushing disease?
Blue-purple
What signs would you note in a patient who has malnutrion
Veins are more visible
Poor turgor
Scaphoid abdomen
Indicators of intestine obstruction
Visible peristalsis
Distended abdomen
What do you asses when percussing the abdomen?
The relative density of abdominal contents and screen for abnormal fluid or masses
Tympany is heard over what kind of organs?
Stomach
Intestines
Dullness is heard over what kind of organs?
Liver
Spleen
How would chronic emphysema effect the abdomen?
The liver would be displaced downward by the hyperinflation of the lungs
Hooking technique
Technique to assess the liver
Hook your fingers under the costal margins from above and ask the patient to inhale, try to find the liver edge
What two assessment test, test for ascites?
Fluid wave
Shifting Dullness
Blumberg sign
When rebound tenderness occurs in the RLQ when pressure is applied to the LLQ
Blumberg sing may indicate ____
Appendicitis
Murphy Sign
When palpating the liver, pain occurs (indication of cholecystitis)
Alvarado Score (MANTRELS Score)
Assist evaluation in patients with RLQ pain
An alvarado score of more than 8 indicates ___
Appendicitis
An infant 4 weeks old presents an umbilical hernia Normal/Abnormal
Normal
Appears 2-3 weeks and usually disappears by 1 year
Drainage after the umbilical cord falls off Normal/Abnormal
Abnormal
What does the abdomen of an infant/child look like?
Protuberant
Obesity inspection
Uniformly round
Umbilicus sunken in
Air/Gas palpation
Muscle spasms of the abdominal wall
Patient with a singe curve of the abdomen, everted umbilicus, glistening skin, tympany in upper quadrants is a patient with ____
Ascites
Ovarian cysts palpation:
Transmits aortic pulsation
Symptoms of intestinal obstruction
Vomiting Absences of stool or gas Strong peristalsis above the obstruction Hypovolemic shock Tenderness Hyperactive bowel sounds Abdominal distension
Hepatitis
Anorexia
Nausea
Malaise
Low grade fever
Liver referral site
Right shoulder
GERD most common symptom
Heartburn
Gallbladder referral site
Right or left scapula
Cholecystitis symptoms
Nausea
Vomiting
Positive murphy sign
Sudden stop in inspiration
When do symptoms of Cholecystitis occur?
After ingesting fatty foods, alcohol, or caffeine
Pancreas referral site
The back, left scapula, or flank
Duodenal ulcer pain is relieved by ___
Food
Stomach referral site
Back or substernal area
What induces gastric ulcer pain?
Food
A patient with appendicitis, pain is aggravated by:
Movement
Coughing
Deep breathing
Irritable bowel syndrome is brought on by ___ and relieved by ___ ____
Meals
Bowel movements
Succussion Splash
Very loud splash sound in upper abdomen when infant is rocked side to side
Indicates increased air and fluid in the stomach
Hypoactive bowel sounds
Result of inflammation (peritonitis)
Result of abdominal surgery, late bowel obstruction, pneumonia
Hyperactive bowel sounds
Borborygmi “stomach growl”
Early bowel obstruction, gastroenteritis, brisk diarrhea, laxative use, and subsiding paralytic ileus
Peritoneal Friction Rub usually indicates ___
Abscess or tumor
