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PCM II Exam I > Competency 1: Abdominal Exam > Flashcards

Competency 1: Abdominal Exam Flashcards

1
Q

Proper order of steps for abdominal exam

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

What are you looking for during inspection of the abdomen?

A
  • Color and pigmentation
  • Contour/symmetry
  • Arterial pulsations
  • Peristalsis
  • Signs of trauma
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3
Q

What is this called; causes?

A
  • Cullen Sign
  • Ecchymosis around the umbilicus (periumbilical) secondary to hemorrhage
  • Pancreatits; ectopic pregnancy
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4
Q

What is this called; causes?

A
  • Grey Turner Sign
  • Ecchymosis of the flanks (pancreatitis)
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5
Q

Why is it important to auscultate before performing perucssion or palpation during an abdominal exam?

A

These maneuvers may alter the frequency of bowel sounds

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6
Q

We listen to bowel sounds w/ what part of diaphram; what is normal and what is abnormal?

A
  • Diaphragm of stethoscope
  • Normal: 5-34 clicks or gurgles/min
  • Abnormal: High pitched or decreased/absent sounds

*Listen in all 4 quadrants

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7
Q

What arteries do we listen to in abdomen; what part of stethoscrope for Bruits and what do Bruits suggest?

A
  • Abdominal aorta, iliac, renal, and femoral arteries
  • BELL of stethoscope for Bruits
  • Bruits suggest vascular occlusion
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8
Q

We percuss the abdomen in all 4 quadrants to assess for?

A
  • The amount and distribution of gas
  • To identify possible masses
  • Estimate the size of the liver and spleen
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9
Q

What sound is heard during percussion over the majority of the abdomen; what other sound may be heard?

A

Tympany: predominate sound in the abdomen‐ high pitched sound heard over air filled viscera

Dullness: non‐resonating/flat sound heard over solid organs or masses

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10
Q

Where do we do percussion of the liver; and what is its normal span?

A
  • Right mid-clavicular line

Normal span:

  • 6-12 cm in right mid-clavicular line
  • 4-8 cm in midsternal line
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11
Q

What is the exprected spleen span and where

A

From ribs 6-10 at the mid-axillary line on the left

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12
Q

What are general considerations for palpation and order of palpation?

A
  • Warm hands, if needed bend pt’s knees to relax abdominal messages, examine most tender areas last
  • Light palpation: up to 1 cm depth
  • Moderate: up to 2-3 cm depth
  • Deep: more than 3 cm depth
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13
Q

What is rebound tenderness; indicates what?

A

Pain upon removal of pressure, rather than the application of pressure to the abdomen; indicates peritoneal inflammation

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14
Q

What is guarding of the abdomen?

A

Voluntary tightening of the abdominal muscles secodary to pain

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15
Q

What is ridgity of the abdomen?

A

Abdomen is hard, involuntary reflex contraction of abdominal wall

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16
Q

What is McBurney’s Point; what can it be indicative of?

A
  • Rebound tenderness or pain 1/3 of the distance from the ASIS to the umbilicus
  • Possible appendicitis/peritoneal inflammation
17
Q

What is Rovsing’s sign and what is it indicative of?

A
  • Pain in the RLQ during left-sided pressure
  • Possible appendicitis (referred rebound tenderness)
18
Q

What is the iliopsoas muscle test and what can it be indicative of?

A
  • Have pt flex their hip against your resistance. Increased abdominal pain is a positive test.
  • Indicates irritation of the psoas muscle from inflammation of the appendix
19
Q

What is the Obturator muscle test and what is it indicative of?

A
  • Flex the pt’s right thigh at the hip, with the knee bent, and IR leg at the hip. Right hypogastric pain is a positive test
  • Indicates irritation of the obturator muscle from inflammation of the appendix
20
Q

What is the heel strike test and what is it indicative of?

A
  • With pt supine, strike patient’s heel. Positive test is abdominal pain.
  • Indicates possible appendicitis or peritonitis
21
Q

What is Murphy’s sign?

A
  • Palpate deeply under right costal margin during inspiration.
  • Positive test is pain and/or sudden stop in inspiratory efford
  • Indicates acute cholecystitis or cholelithiasis
22
Q

What is Courvoisier’s Sign; indicates?

A

Enlarged non-tender gallbladder. Indicative of pancreatic disease/cancer

23
Q

What is Lloyd punch/CVA tenderness; indicates?

A
  • Gently tap the area of the back overlying the kidney (costovertebral angles). Positive test is pain
  • Indicates an infection around the kidney (perinephric abscess), pyelonephritis, or renal stone
24
Q

How is abdominal aorta palpation performed; expected width and direction of pulsation?

A
  • Palpate just above umbilicus, slightly to the left of midline
  • Expected width: 2-3 cm, pulsation is an anterior-inferior direction
  • Unexpected: >3cm in width, prominent lateral pulsation

PCM II Exam I (9 decks)

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