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OMS Year I Block II - Comprehensive Deck > Clinical Medicine - Abdomen (Lab Portion) > Flashcards

Clinical Medicine - Abdomen (Lab Portion) Flashcards

1
Q

Abdominal exam is done in the following order:

A
  1. Inspection
  2. Ausculation
  3. Percussion
  4. Palpation

Very important for OSCE!

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2
Q

The patient should be in what anatomical position when doing an abdominal exam?

A

Supine

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3
Q

The two main points to make sure you do when inspecting are:

A
  1. Verbalize what you see
  2. Drape properly (life up shirt to bra line/rib area and tuck drape into pants)
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4
Q

What is the proper way to verbalize your findings on the inspection portion of the exam?

A

“I see no scars, masses, discoloration, bruising, ascites”

You could potentially see positive Cullen’s sign/Grey-Turner’s sign or Linea Nigra

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5
Q

For auscultation portion of the exam, you listen to all 4 quadrants with what portion of the stethoscope?

A

The Diaphragm

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6
Q

For aortic bruits, you would use what portion of the stethoscope and where would these typically be found?

A
  1. The bell
  2. Left Upper Quadrant
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7
Q

For the percussion portion of the abdominal exam, you don’t want to hear a large area of dullness unless you are percussing over what two structures?

A
  1. Liver
  2. Spleen

See organ placement diagram

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8
Q

When percussing, what tells you that there is no sign of spleenomegaly?

A

You will hear tympany

You will go to anterior axillary line along last intercostal space - make sure they hold their breath in between

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9
Q

When you are palpating, you are doing so to elicit what?

A

PAIN

Make sure to do all four quadrants and do light + deep palpation

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10
Q

If the right upper quadrant is painful to palpation, that could be due to…(try to name 2-3 of them)

A
  1. Liver pain
  2. hepatitis
  3. gallbladder pain
  4. part of pancreas
  5. transverse colon spans both RUQ and LUQ
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11
Q

If the left upper quadrant is painful to palpation, that could be due to…(try to name 2-3 of them)

A
  1. Stomach
  2. Spleen
  3. Rest of pancreas
  4. transverse colon spans both RUQ and LUQ
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12
Q

What organ is in both lower quadrants?

A

Small Intestine

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13
Q

What part of the colon is in the RLQ?

A

Ascending Colon

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14
Q

What part(s) of the colon is in the LLQ?

A
  1. Descending Colon
  2. Sigmoid Colon
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15
Q

If the patient describes burning in the upper quadrants, you will want to think what?

A

Ulcers (duodenal in RUQ or gastric in LUQ)

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16
Q

If the patient describes cramping, think (name 2)

A
  1. Biliary Colic
  2. Gallstones
17
Q

If the patient describes a tearing or ripping feeling, this could be a…

A

Aortic Dissection - VERY BAD –> GO TO ER

18
Q

When you find a tender area of the abdomen, you will utilize the test for what we call ________, and make sure to ask them if it hurts more when you ________ in or when you ________ away

A
  1. Rebound Tenderness
  2. Push
  3. Pull
19
Q

Mcburney’s Point/sign is an indication of…

A

Appendicitis

amongst other things

20
Q

Rovsing’s Sign (while outdated) is when you palpate the LLQ, but the pain shows up in the…and is used for an indication of what?

A
  1. RLQ
  2. Appendicitis
21
Q

A Murphy’s Sign is when you ask the patient to inhale in ________ quadrant while palpating, and if they experience pain or stop inhaling, that is an indication of/concerning for….

A

Gallstones

inflammation of gallbladder

usually done with liver palpation

22
Q

Iliopsoas/Obturator test is used to test for…

A

peritoneal inflammation

not a great test because people’s lack of flexibility takes away from the specificity of the test - Iliopsoas test = bring straight leg up and have patient push against resistance and Obturator test = bent knee to 90 and internally + externally rotate the knee

23
Q

The heel jar test is performed to test for…

A

Peritoneal inflammation

A question to ask and put in history is - “did the car drive over bring about any pain such as going over bumps on the road?”

24
Q

Lloyd’s Test is performed to test for…and the patient is in what position?

A
  1. Kidney Stones
  2. Seated upright
25
Q

Fluid wave test is performed to test for….

A

Ascites - AKA fluid back up in the abdomen

OMS Year I Block II - Comprehensive Deck (3 decks)

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