Exam 3 - Abdomen Flashcards
largest cavity in the body
abdomen
abdominal landmarks
xiphoid process
umbilicus
pubic bones
**specified in PPT
costal margin
iliac crests
how may abdominal quadrants are there?
4
anatomic structures located midline?
aorta
bladder
uterus
what does the RUQ contain?
liver gallbladder pyloric sphincter duodenum pancreas (head) R kidney + R adrenal gland ascending, transverse colon
What does the RLQ contain?
cecum appendix ascending colon R ovary, uterine tube R ureter R spermatic cord
what does the LUQ contain?
L lobe of liver spleen stomach pancreas (body) L kidney + L adrenal gland splenic flexure of colon transverse, descending colon
what does the LLQ contain?
sigmoid colon descending colon L ovary + uterine tube L ureter L spermatic cord
where do you palpate if you suspect your pt has bladder distention?
suprapubic
what is the area superior to the umbilicus?
epigastric
what is the area inferior to the umbilicus?
suprapubic
where is referred gallbladder pain felt?
scapular region
what is included in a function assessment?
diet
eating alone
bottle feeding
introduction of solid food
labs re: stomach
H. Pylori
labs re: liver
ALT, AST, ALP LDH hepatic antigens bilirubin ammonia albumin
labs re: pancreas
amylase
lipase
glucose
calcium
pt positioning for abdominal exam
supine
head on pillow
knees bent
arms at side or across chest
horizontal line from the costal margin to suprapubic is straight
flat abdomen
horizontal line from the costal margin to suprapubic is curved outward
round, convex
*normal finding in toddler, pregnancy
horizontal line from costal margin to suprapubic is greater curved outward; stretched appearance
protuberant
*anticipated in pregnancy; can be seen with obesity, ascites
horizontal line from costal margin to suprapubic is curves inward, sunken appearance
scaphoid, concave
weakness in the abdominal wall/muscle that bowel protrudes through
hernia
types of hernias
ventral
umbilical
inguinal
who may you seen pulsations in?
thin individuals
which quadrant do you start in when listening to abdominal sounds?
RLQ
how long to auscultate for absent bowel sounds?
5 minutes
very hyperactive bowel sounds are called
borborygymus
borborygmus is indicative of
bowel obstruction
ileus
how to test for pyelonephritis
percuss CVA
when do you palpate a tender area?
last
if pt has possible appendicitis, aortic aneurysm, or recent organ transplant, or polycysistic kidneys, would you palpate the abdomen?
No.
how far to press for light palpation
1 cm
how far to press for deep plapation
5 cm
may need 2 hands
s/sx of pertonitis
abdomen rigid, hard, distended, tender
N/VD
fever, chills
causes of pertonitis
ruptured organ
free air in abdomen
trauma
colicky pain
sharp, localized GI or renal pain
comes in goes in wavelike spasms; restlessness
what can cause a false positive occult blood
eating red meat
how many more times do you have to perform a guiac test if the first one is positive
2
what to ask pts before a guiac test?
any recent black, tarry stools
meds that can cause GI bleeds
ASA
arthritis meds/NSAIDS
steriods
what can cause GI bleed
ulcers
diverticulitis
colon/rectal cancer
hemorrhoids
colon, rectal cancer risk factors
smoking high red meat diet obesity diabetes family hx
if you can feel the spleen, what should you do?
stop palpating, this is an abnormal finding.
the spleen should not be palpable
how to assess for rebound tenderness
push down slowly and deeply in an area away from the painful area
release quickly
what occurs during abnormal rebound tenderness
pain after area is release
what is a + rebound tenderness called
Blumberg’s sign
how to assess for cholecystitis
push into RUQ
pt takes a deep breath in
pain felt on inspiration is abnormal
test used to assess for cholecystitis
Murphy’s sign
how to assess for appendicitis
pt lies supine, lift R leg
pt keeps leg up
push down on R thigh
abnormal: pain, can not keep leg raised
elderly have slower gastric emptying which puts them at risk for
aspiration
considerations for elderly abdominal assessment
increase fat abdomen, hips decreased muscle tone palpate organs easier c/o less pain dry mouth slower esophageal, gastric emptying decrease absorption of nutrients, vitamins and minerals increase diverticulosis, gallbladder disease slow med metabolism constipation anorexia
