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EC Health Assessment > Chapter 22: Abdomen > Flashcards

Chapter 22: Abdomen Flashcards

1
Q

Aneurysm

A

Defect of sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect

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2
Q

Anorexia

A

Loss of appetite for food

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3
Q

Ascites

A

Abnormal accumulation of serous fluid within the peritoneal cavity, associated with heart failure, cirrhosis, cancer, or portal hypertension

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4
Q

Borborygmi

A

Loud, gurgling bowel sounds signaling increased motility or hyper-peristalsis; occurs with early bowel obstruction, gastroenteritis, diarrhea

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5
Q

Bruit

A

Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded

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6
Q

Cecum

A

First or proximal part of large intestine

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7
Q

Cholecystitis

A

Inflammation of the gallbladder

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8
Q

Costal margin

A

Lower border of rib margin formed by the medial edges of the 8th, 9th, and 10th ribs

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9
Q

Costovertebral angle (CVA)

A

Angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney

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10
Q

Diastasis recti

A

Midline longitudinal ridge in the abdomen, a separation of abdominal rectus muscles

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11
Q

Dysphagia

A

Difficulty swallowing

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12
Q

Epigastrium

A

Name of abdominal region between the costal margins

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13
Q

Hepatomegaly

A

Abnormal enlargement of liver

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14
Q

Hernia

A

Abnormal protrusion of bowel through weakening in abdominal musculature

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15
Q

Inguinal ligament

A

Ligament extending from pubic bone to anterior superior iliac spine, forming lower border of abdomen

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16
Q

Linea alba

A

Midline tendinous seam joining the abdominal muscles

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17
Q

Paralytic ileus

A

Complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction

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18
Q

Peritoneal friction rub

A

Rough grating sound heard through the stethoscope over the site of peritoneal inflammation

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19
Q

Peritoneum

A

Double envelope of serous membrane that lines the abdominal wall and covers the surface of most abdominal organs

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20
Q

Peritonitis

A

Inflammation of peritoneum

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21
Q

Pyloric stenosis

A

Congenital narrowing of pyloric sphincter, forming outflow obstruction of stomach

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22
Q

Pyrosis

A

Heartburn; burning sensation in upper abdomen due to gastric reflux of gastric acid

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23
Q

Rectus abdominis muscles

A

Midline abdominal muscles extending from rib cage to pubic bone

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24
Q

Scaphoid

A

Abnormally sunken abdominal wall, as with malnutrition or underweight

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25
Q

Splenomegaly

A

Abnormal enlargement of the spleen

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26
Q

Striae

A

(Linea albicantes) silvery white or pink scar tissue formed by stretching abdominal skin as with pregnancy or obesity

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27
Q

Suprapubic

A

Name of abdominal region just superior to pubic bone

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28
Q

Tympany

A

High-pitched, musical, drumlike percussion note heard when percussing over the stomach and intestine

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29
Q

Umbilicus

A

Depression on the abdomen marking site of entry of umbilical cord

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30
Q

Viscera

A

Internal organs

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31
Q

Describe the proper positioning and preparation of the patient for the abdominal examination

A

Supine with head on pillow, knees bent, and arms at their side or across their chest.

Warm room, hands, and stethoscope.

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32
Q

Discuss the inspection of the abdomen, including findings that you should note.

A

Contour, color, symmetry, umbilicus, skin, pulsation/movement, hair distribution, and demeaner.

Note: bulges, masses, unusual movement, and colors.

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33
Q

State the rationale for performing auscultation of the abdomen before palpation or percussion.

A

Palpation and percussion may stimulate peristalsis - can cause hyperactive bowel sounds.

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34
Q

Describe the procedure for auscultation of bowel sounds.

A

Start in the RLQ at ileocecal valve (sounds are normally present here).

Continue clockwise.

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35
Q

Differentiate the following abdominal sounds: normal, hyperactive, and hypoactive bowel sounds; succession splash; bruit

A

Normal: high-pitched, gurgling, cascading.

Hyperactive: loud, high-pitched, rushing, tinkling, borborygmus (stomach growling).

Hypoactive: reduction in loudness, tones, or regularity.

Succession splash: sloshing sounds.

“Thrill”: turbulent blood flow.

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36
Q

List 4 conditions that may alter normal percussion notes heard over the abdomen

A
  • Pregnancy
  • Obesity
  • Ascites
  • Air/gas distention
  • Tumor
  • Fecal - intestinal blockage
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37
Q

Name the organs that are normally palpable in the abdomen

A
  • Liver
  • Right kidney
  • Pulsatile aorta
  • Rectus muscles
  • Ascending colon
  • Cecum
  • Sigmoid colon
  • Uterus (gravid)
  • Full bladder
  • Sacral promontory
38
Q

Differentiate between light and deep palpation, and explain the purpose of each.

A
  • Light palpation: about 1 cm; forms an overall impression of skin surface and superficial musculature
  • Deep palpation: about 5 to 8 cm; palpation of organs
39
Q

List 2 abnormalities that may be detected by light palpation and 2 that may be detected by deep palpation.

A
  • Light palpation
    • Muscle gaurding
    • Rigidity
    • Large masses
    • Tenderness
  • Deep palpaption
    • Enlarged liver
    • Enlarged spleen
    • Enlarged kidneys/masses
    • Aortic aneurysm
40
Q

Contrast rigidity with voluntary guarding.

A

Involuntary rigidity: a constant, boardlike hardness of the muscles; protective mechanism accompanying acute inflammation of peritoneum

Voluntary guarding: occurs when cold, ticklish, or tense

41
Q

Contrast visceral pain and somatic (parietal) pain

A

Visceral pain: due to organ damage/inflammation/disease

Somatic (parietal) pain: from skin, muscle and soft tissue damage/injury

42
Q

Describe rebound tenderness.

A

Assess when person reports abdominal pain or tenderness is elicit during palpation.

Hold hand at 90 degrees to abdomen, press down slowly and deeply, then lift up quickly - normally no pain.

43
Q

Distinguish abdominal wall masses from intra-abdominal masses,

A

Abdominal wall masses:

  • Umbilical, epigastric, incisional, or spigelian hernias
  • Benign and malignant neoplasm
  • Infections
  • Hematomas

Intra-abdominal masses:

  • Localized sweeling/enlargement of the abdomen
44
Q

Describe the procedure and rationale for determining costovertebral angle (CVA) tenderness

A
  1. Place one hand over the 12th rib at the CVA on the back
  2. Thump that hand with ulnar edge of other first

Normal: feel thud, no pain

Abnormal: feel sharp pain (kidney or paranephric area inflammation)

45
Q

Identify label a

46
Q

Identify label b

A

Gallbladder

47
Q

Identify label c

A

Ascending colon

48
Q

Identify label d

A

Small intestine

49
Q

Identify label e

50
Q

Identify label f

51
Q

Identify label g

52
Q

Identify label h

53
Q

Identify label i

A

Transverse colon

54
Q

Identify label j

A

Descending colon

55
Q

Identify label k

A

Sigmoid colon

56
Q

Identify label l

57
Q

Identify label a

A

Inferior vena cava

58
Q

Identify label b

A

Right kidney

59
Q

Identify label c

60
Q

Identify label d

61
Q

Identify label e

A

Right ureter

62
Q

Identify label f

A

Sacral promontory

63
Q

Identify label g

A

External iliac artery

64
Q

Identify label h

A

External iliac vein

65
Q

Identify label i

66
Q

Identify label j

67
Q

Identify label k

68
Q

Identify label l

A

Left kidney

69
Q

Identify label m

A

Small intestine

70
Q

Identify label n

A

Left ureter

71
Q

Identify label o

A

Common iliac artery

72
Q

Identify label p

A

Common iliac vein

73
Q

Identify label q

A

Peritoneum

74
Q

Identify label r

75
Q

Identify label s

76
Q

Identify label t

A

Pubic symphysis

77
Q

Select the sequence of techniques used during an examination of the abdomen.

a. Precussion, inspection, palpation, auscultation
b. Inspection, palpation, percussion, auscultation
c. Inspection, auscultation, percussion, palpation
d. Auscultation, inspection, palpation, percussion

A

c. Inspection, auscultation, percussion, palpation

78
Q

Which of the following can be noted through inspection of a patient’s abdomen?

a. Fluid waves and abdominal rigidity
b. Umbilical eversion and Murphy sign
c. Venous pattern, peristaltic waves, and abdominal contour
d. Peritoneal irritation, general tympany, and peristaltic waves

A

c. Venous pattern, peristaltic waves, and abdominal contour

79
Q

Right upper quadrant tenderness may indicate pathology in the:

a. Liver, pancreas, or ascending colon
b. Liver and stomach
c. Sigmoid colon, spleen, or rectum
d. Appendix or ileocecal valve

A

a. Liver, pancreas, or ascending colon

80
Q

Hyperactive bowel sounds are:

a. High-pitched
b. Rushing
c. Tinkling
d. All of the above

A

d. All of the above

81
Q

The abscence of bowel sounds is established after listening for:

a. 1 full minute
b. 3 full minutes
c. 5 full minutes
d. None of the above

A

c. 5 full minutes

82
Q

Auscultation of the abdomen may reveal bruits of the _____ arteries.

a. Aortic, renal, iliac, and femoral
b. Jugular, aortic, carotid, and femoral
c. Pulmonic, aortic, and portal
d. Renal, iliac, internal jugular, and basilic

A

a. Aortic, renal, iliac, and femoral

83
Q

The left upper quadrant (LUQ) contains the:

a. Liver
b. Appendix
c. Left ovary
d. Spleen

84
Q

A woman has striae on the abdomen. Which color indicates long-standing striae?

a. Pink
b. Blue
c. Purple-blue
d. Silvery white

A

d. Silvery white

85
Q

Auscultating the abdomen is begun in the right lower quadrant (RLQ) because:

a. Bowel sounds are always normally present here
b. Peristalsis through the descending colon is usually active
c. This is the location of the pyloric sphincter
d. Vascular sounds are best heard in this area

A

a. Bowel sounds are always normally present here

86
Q

Shifting dullness is a test for:

a. Ascites
b. Splenic enlargment
c. Inflammation of the kidney
d. Hepatomegaly

A

a. Ascites

87
Q

Tenderness during abdominal palpation is expected when palpating the:

a. Liver edge
b. Spleen
c. Sigmoid colon
d. Kidneys

A

c. Sigmoid colon

88
Q

A positive Murphy sign is best described as:

a. The pain felt when the examiner’s hand is rapidly removed from an inflamed appendix
b. Pain felt when taking a deep breath when the examiner’s fingers are on the approximate location of the inflammed gallbladder
c. A sharp pain felt by the patient when one hand of the examiner is used to thumb the other at the costovertebral angle
d. This is not a valid examination technique

A

b. Pain felt when taking a deep breath when the examiner’s fingers are on the approximate location of the inflammed gallbladder

89
Q

A positive Blumberg sign indicates:

a. Possible aoritc aneurysm
b. Presence of renal artery stenosis
c. Enlarged, nodular liver
d. Peritoneal inflammation

A

d. Peritoneal inflammation

90
Q

Your patient is complaining of abdominal pain. What are some common sites of referred abdominal pain? What subjective data may be necessary to determine what is wrong with the patient?

A
  • Liver: mild-to-moderate dull pain in RUQ or epigastrum
  • Esophagus: burning pain in midepigastrium
  • Gallbladder: sudden pain in RUQ that may radiate to right or left scapula
  • Pancreas: acute, boring midepigastric pain radiating to the back and sometimes to the left scapula or flank, severe nausea, and vomiting
  • Duodenum: typically dull, aching, gnawing pain; noes not radiate
  • Stomach: dull, aching, gnawing epigastric pain, radiates to back or substernal area
  • Appendix: starts as dull, diffuse pain in periumbilical region that later shifts to severe, sharp, persistent pain and tenderness; pain aggrevated by movement, coughing, deep breathing
  • Kidney: sudden onst of severe flank or lower abdominal pain
  • Small intestine: diffuse, generalized abdominal pain
  • Colon: moderate, colicky pain of gradual onset in lower abdomen and bloating

EC Health Assessment (14 decks)

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