Exam 2- Module 6 Flashcards
Constipation
Decreased physical activity, water, low fiber diet, medications, IBS, hypothyroidism
Abdomen inspection
Contour : stand on R side person lying, head should be slightly higher than abdomen, determine rib margin
Symmetry: shine light across abdomen toward you or lengthwise across person, symmetric bilaterally
Umbilicus: midline and inverted, no discoloration, inflammation or hernia
Skin: smooth and even, skin tugor
Pulsation of movement: pulsations of Aorta
Hair distribution: diamond female and triangle male
Demeanor: person is relaxed, facial expression
Bowel sounds
Percussion and palpation increase peristalsis -false interpretation
Diaphragm endpiece -high pitched
Hold lightly against skin
Begin in RLQ usually present here
Note character and frequency
Liver assessment
Measure height of liver in right midclavicular line
Usually 5th intercostal space
Dull sound should be heard
Normal liver span 6-12cm adults: correlates with height
Liver span: scratch test
Define liver border when abdomen or abdominal muscles are tense
Place stethoscope over liver
Scratch short strokes in RLQ and move up to liver
When scratching sounds become magnified you have crossed border over hollow organ to solid one
Palpation of liver
Place left hand under persons 11th/12th ribs
RUQ
Push deeply
Have person take deep breath to feel edge of liver
Often not palpable
Booking technique
Alternative method to palpate liver
Hook fingers over costal margin from above
Take deep breath
Feel liver bump finger tips
Abnormal findings: abdominal dissension
Obesity Air or gas Ascites Ovarian cyst Pregnancy Feces Tumor
Abnormal findings: abdomen inspection
Umbilical hernia
Epigastric hernia
Incisional hernia
Diastasis Recti
Abnormal bowel sounds
Succussion splash
Hypoactive
Hyperactive
Abnormal findings: friction rubs and vascular sounds
Peritoneal friction rub
Arterial bruit
Venous hum
Abnormal findings: palpation of enlarged organs
Liver Nodular liver Gallbladder Spleen Kidney Aneurysm
Peritoneal inflammation
Pain or release of pressure (rebound tenderness)
Accompanies appendicitis
Cough tenderness located in specific spot
Cystitis: male
Burning when urinating
Urinary tract infection
Nephrolithiasis
Small
Hard deposit
Forms in kidneys
Painful when passed
UTI
Urinary tract infection
Burning upon urination
Frequent or urge to urinate
Pain or pressure in back or lower abdomen
Cloudy, dark, bloody, abnormal smelling urine
UTI cause
Infection in bladder: cystitis
E. coli in GI tract
UTI risk factors
Blockage in urinary tract
Kidney stones
Enlarged prostate can trap urine in bladder
Women (shorter urethra for bacteria to move), diabetes
Guaiac test
Looks for hidden (occult) blood in stool sample
Most common type of fecal occult blood test (FOBT)
Bronchovesicular sounds
Mid chest
Posterior chest behind scapula
Reflect a mixture of the pitch of the bronchial breath sounds heard near the trachea and the alveoli with the vesicular sound
Vesicular sound
heard over the thorax
lower pitched
softer than bronchial breathing
Bronchial sounds
over the trachea has a higher pitch
louder
inspiration and expiration are equal and there is a pause between inspiration and expiration
Atrophic vaginitis
also known as vaginal atrophy
inflammation of the vagina (and the outer urinary tract)
thinning and shrinking of the tissues
decreased lubrication
lack of the reproductive hormone estrogen
Cytocele
Bladder hernia
Supportive tissue between woman’s bladder and vagina wall Weakens and stretches
Bladder bulges into vagina
Cause: child birth, heavy lifting, constipation
