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MSS - PCM 2 Exam 1 > Exam of the Abdomen > Flashcards

Exam of the Abdomen Flashcards

1
Q

dysphagia

A

difficulty in swallowing

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2
Q

visceral pain

A 
colic pain
in hollow organs
-distension or stretching
-comes and goes
not well localized (innervation autonomic)
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3
Q

parietal pain

A

inflammation of peritoneum

-steady aching pain well localized

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4
Q

referred pain

A

right shoulder - gallbladder
left shoulder - spleen
back - pancreas/aorta

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5
Q

right shoulder pain

A

gallbladder

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6
Q

left shoulder pain

A

spleen

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7
Q

flank pain

A

kidney

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8
Q

back pain

A

pancreas or aorta

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9
Q

physical exam of abdomen includes?

A 
inspection
auscultation
percussion
palpation
rectal examination
special techniques
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10
Q

adequate exposure of abdomen?

A

xiphoid to pubis

necessary for inspection

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11
Q

best place to listen to cecum?

A

right lower quadrant

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12
Q

normal bowel sounds

A

high pitched tinkle every 3-5 seconds

sound of bowel sounds is peristalsis

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13
Q

when to do auscultation

A

BEFORE palpation

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14
Q

barborygmi

A

increased hyperactive bowel sounds
low pitched rumbling
hyperperistalsis

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15
Q

abdominal bruits

A

soft sound made by disrupted arterial flow through narrow artery

aortic
renal
femoral

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16
Q

aortic bruits?

A

between umbilicus and xiphoid

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17
Q

renal artery bruit?

A

lateral to aorta

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18
Q

femoral artery bruit?

A

along inguinal ligament

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19
Q

best position for palpation?

A

supine

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20
Q

tympanic sound

A

gas in stomach and small bowel

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21
Q

percussion of liver

A

resonant to dull to tympanic **

right mid-clavicular line

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22
Q

normal liver size

A

less than 10cm

23
Q

ascites

A

fluid

24
Q

fluid wave

A

tap on flank and palpate other side
-impulse indicates ascites

have assistants hands midline - stops wave through adipose tissue

25
Q

shifting dullness

A

percuss patient on back and then side

note where changes of sound from tympany to dull and shift of sound when patient is turned on side

26
Q

segments of palpation?

A 
light
deep
liver
spleen
kidney
rebound
27
Q

light palpation

A

one hand
-finger tips with gentle motion

all four quadrants

28
Q

deep palpation

A

one hand on top of the other

top push/bottom palpate

29
Q

rebound tenderness

A

shows peritoneal tenderness

-slowly, gently, deeply palpate and quickly remove

30
Q

rovsings sign

A

referred rebound tenderness

ex/

  • press on LLQ and release
  • positive if pain in RLQ

often with appendicitis

31
Q

liver palpation

A

right hand under 11th and 12th rib (RUQ)

have patient breathe deeply as examiner presses inward and upward

-better palpation of liver on inhalation (diaphragm pushes it down

32
Q

hooking technique

A

stand near patients head
hook fingers around lower right ribs

have patient breathe while pulling inward and upward

33
Q

spleen palpation

A

left hand under 11th 12th ribs
right hand in LUQ under costal margin

spleen normally not palpated

34
Q

palpation of aorta

A

press firmly and deep in the upper abdomen with two hands

35
Q

aortic aneurysm

A

pathologic dilation of aorta

36
Q

palpation of kidney

A

sandwich method

normally not palpated

37
Q

percussion of kidneys

A

aka CVA tenderness

fist gently hit over area

pain may indicate an inflammatory infectious process of kidney

38
Q

CVA tenderness

A

lloyds sign

level of T12

aka lloyds sign

percussion of kidneys

39
Q

rectal examination

A

every abdominal examination should conclude with a DRE

40
Q

modified lithotomy

A

patient on back

41
Q

sims patient

A

patient on left side

42
Q

standing position

A

standing, bent over exam table

43
Q

rectal exam

A

inspect
-spread buttocks

palpation

  • insert lubed finger and rotate 180 degrees
  • in male feel prostate
44
Q

fecal occult blood testing

A

positive test requires a thorough evaluation for CRC

either colonoscopy or sigmoidoscopy with air contrast barium enema

45
Q

prolapsed internal hemorrhoid

A

comes out of anus

46
Q

anal warts

A

HPV - condyloma acuminata**

syphylis - condylomata lata**

47
Q

appendicitis

A

obstruction of appendicular lumen

pain peri-umbilical then shifts to right lower quadrant
-nausea and vomiting, anorexia, fever

48
Q

obturator sign

A

right leg in figure 4
-press on right knee while holding down left iliac crest

always do rectal and pelvic on female**

49
Q

psoas sign

A

extend leg

check for psoas muscle inflammation

50
Q

acute cholecystitis

A

obstruction of cystic duct by gall stone

RUQ pain, N/V, anorexia, obesity, fever

pain comes and goes

pain radiates to shoulder

5 f’s - female, fat, fertile, fair, flatulent’

elevate direct bilirubin

51
Q

murphys sign

A

RUQ pain and arrest of inspiration during palpation

acute cholecystitis

52
Q

diagnostic triad

A

RUQ pain, fever, leukocytosis

53
Q

nine regions of abdomen

A

epigastric, umbilical, suprapubic
R/L hypochondrium
R/L lumbar
R/L inguinal

MSS - PCM 2 Exam 1 (7 decks)

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