Exam 3 Study Guide Part 1 Flashcards
(29 cards)
Hernia
In relation to the genitalia examination, weakness in the abdominal wall often allowing protrusion of abdominal contents into the inguinal or femoral canals
Femoral Hernia
- A bulge of the femoral canal suggests a femoral hernia
- Most frequent type of hernias in females
Inguinal Hernia
-A bulge of the inguinal canal
Bowel Sounds
- Sounds created as a result of peristalsis
- Contents of the bowel are being moved through the alimentary tract
- This makes intermittent clicks & gurgles
Normal Frequency of Bowel Sounds
5-34 per minute
Borborygmus
- 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
Hepatic/Venous Hum
Continuous low-grade humming associated w/ increased circulation between the portal and venous vessels in patients with cirrhosis of the liver
Hypoactive Bowel Sounds
- Less than 5 sounds per minute (or absent)
- Continue auscultation for up to 2 minutes
- Found in ileus, paralysis of the bowel, and peritonitis
Hyperactive Bowel Sounds
- 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
What is the initial step in examination of the abdomen (inspection, palpation, percussion, auscultation
Inspection
What are the four quadrants of the abdomen?
- Right Upper Quadrant (RUQ)
- Left Upper Quadrant (LUQ)
- Right Lower Quadrant (RLQ)
- Left Lower Quadrant (LLQ)
Why do you not palpate the abdomen prior to auscultation?
Allows for proper assessment of bowel sounds, which can be altered by palpatory techniques
What is a venous hum?
- Hepatic/Venous Hum
- Continuous low-grade humming associated w/ increased circulation between the portal and venous vessels in patients with cirrhosis of the liver
Light palpation and deep palpation are utilized to identify what respectively?
- 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
Risk factors associated with abdominal aortic aneurysm
- Age 60 or older (sixties)
- History of smoking
The symptom that is a sign of acute peritonitis on physical examination of the abdominal muscles is called what?
Rigidity
Rigidity
- 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
Rebound tenderness, fever, hypoactive bowel sounds and acute pain in the RLQ is indicative of what disease?
Acute peritonitis
Rebound Tenderness
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
Roving’s Sign is solicited by pressing down on the LLQ with an increase in RLQ pain and is indicative of what disease?
Appendicitis
Rovsing’s sign
- 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
Psoas sign is indicative of what disease?
Inflamed appendix/acute appendicitis
Psoas sign
- 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
Murphy’s sign is indicative of what condition?
Cholecystitis
