Exam 3 Study Guide Part 1

Question 1

Hernia

Answer 1

In relation to the genitalia examination, weakness in the abdominal wall often allowing protrusion of abdominal contents into the inguinal or femoral canals

Question 2

Femoral Hernia

Answer 2

• A bulge of the femoral canal suggests a femoral hernia

- Most frequent type of hernias in females

Question 3

Inguinal Hernia

Answer 3

-A bulge of the inguinal canal

Question 4

Bowel Sounds

Answer 4

• Sounds created as a result of peristalsis
• Contents of the bowel are being moved through the alimentary tract
• This makes intermittent clicks & gurgles

Question 5

Normal Frequency of Bowel Sounds

Answer 5

5-34 per minute

Question 6

Borborygmus

Answer 6

• Rumbling & gurgling sound of air passage through the fluids of the large bowel
• Part of everyday sounds of healthy bowel function
• May be absent in patients w/ ileus/obstruction from bowel torsion, volvulus, or strangulation

Question 7

Hepatic/Venous Hum

Answer 7

Continuous low-grade humming associated w/ increased circulation between the portal and venous vessels in patients with cirrhosis of the liver

Question 8

Hypoactive Bowel Sounds

Answer 8

• Less than 5 sounds per minute (or absent)
• Continue auscultation for up to 2 minutes
• Found in ileus, paralysis of the bowel, and peritonitis

Question 9

Hyperactive Bowel Sounds

Answer 9

• Greater than 34 sounds per minute
• May be from irritation, infection, or inflammation of bowel
• Hyperactive, high-pitched, or tinkling sounds happen w/ bowel obstruction

Question 10

What is the initial step in examination of the abdomen (inspection, palpation, percussion, auscultation

Answer 10

Inspection

Question 11

What are the four quadrants of the abdomen?

Answer 11

• Right Upper Quadrant (RUQ)
• Left Upper Quadrant (LUQ)
• Right Lower Quadrant (RLQ)
• Left Lower Quadrant (LLQ)

Question 12

Why do you not palpate the abdomen prior to auscultation?

Answer 12

Allows for proper assessment of bowel sounds, which can be altered by palpatory techniques

Question 13

What is a venous hum?

Answer 13

• Hepatic/Venous Hum
• Continuous low-grade humming associated w/ increased circulation between the portal and venous vessels in patients with cirrhosis of the liver

Question 14

Light palpation and deep palpation are utilized to identify what respectively?

Answer 14

• Light - uses a circular motion to assess the skin and subcutaneous tissue for tenderness or masses
• Deep - a rolling, kneading motion to assess for tenderness and the deep structures of the abdomen

Question 15

Risk factors associated with abdominal aortic aneurysm

Answer 15

• Age 60 or older (sixties)

- History of smoking

Question 16

The symptom that is a sign of acute peritonitis on physical examination of the abdominal muscles is called what?

Answer 16

Rigidity

Question 17

Rigidity

Answer 17

• Sign of acute peritonitis on physical examination
• The abdominal muscles are board-like due to severe irritation of the peritoneum
• May be hot to the touch
• Patient may flex into the fetal position to decrease stretching of the abdominal wall

Question 18

Rebound tenderness, fever, hypoactive bowel sounds and acute pain in the RLQ is indicative of what disease?

Answer 18

Acute peritonitis

Question 19

Rebound Tenderness

Answer 19

The provider compares pain experienced by the patient with deep palpation of the abdomen versus pain experienced with the sudden lifting of the hand off the abdomen from a depressed position. Increased pain with lifting suggests acute peritonitis

Question 20

Roving’s Sign is solicited by pressing down on the LLQ with an increase in RLQ pain and is indicative of what disease?

Answer 20

Appendicitis

Question 21

Rovsing’s sign

Answer 21

• The provider presses slowly but firmly down on the LLQ, asking the patient if it causes or worsens the RLQ pain
• If so, this is a positive Rovsing’s sign and increases the probability of appendicitis

Question 22

Psoas sign is indicative of what disease?

Answer 22

Inflamed appendix/acute appendicitis

Question 23

Psoas sign

Answer 23

• A patient presents with RLQ abdominal pain where the provider resists attempted flexion at the hip by the patient
• This causes the iliopsoas muscle group to contract, moving the inflamed sheath and causing pain if the appendix is in a retrocecal position
• Helps find the position of the appendix

Question 24

Murphy’s sign is indicative of what condition?

Answer 24

Cholecystitis

Question 25

Active Range of Motion (AROM)

Answer 25

Action of the patient moving a joint to the greatest degree possible in all planes of motion

Question 26

Following a stroke, Ms. Martin shows residual weakness in right shoulder abduction. She is able to abduct her shoulder against gravity but is unable to do so against any resistance. How would this be scaled?

Answer 26

3/5

Question 27

Wrist Range of Motion - Flexion & Extension

Answer 27

• Flexion – 0-80 degrees

- Extension – 0-70 degrees

Question 28

Wrist Range of Motion - Radial & Ulnar

Answer 28

• Radial Deviation – 0-20 degrees

- Ulnar Deviation – 0-30 degrees

Question 29

Wrist Range of Motion - Supination & Pronation

Answer 29

• Supination – 0-80 degrees

- Pronation – 0-80 degrees