GI Flashcards
Order of GI examination
Inspection
Auscultation
Percussion
Palpation
Looking for during abdominal inspection
skin characteristics symmetry surface motion masses hernias
Where do you listen for friction rubs?
liver or spleen
In Epigastric region
pylorus
duodenum
pancreas
portion of liver
umbilical region
omentum
mesentery
lower part of duodenum
jejunum & ileum
left lumbar region
descending colon
lower half of left kidney
portions of jejunum & ileum
left inguinal region
sigmoid colon
left ureter
left spermatic cord
left ovary
right inguinal region
cecum appendix distal ileum R ureter R spermatic cord R ovary
presence of scarring should alert to the possibility of
adhesions
limited abdominal movement associated with respiration in adult males
peritonitis
loud prolonged gurgles
boborygmi
tinkling bowel sounds
intestinal fluid & air under pressure = early obstruction
decreased bowel sounds
peritonitis
paralytic ileus
abdominal friction rub indicates
inflammation of the peritoneal surface of the organ from tumor, infection or infarct
What is assessed by percussion of the R and L costovertebral angles?
kidney tenderness
Light palpation in all 4 abdominal quadrants assesses
guarding (muscle resistance)
tenderness
masses
Deep palpation is to identify
ID liver border ID bulges/masses around umbilicus uncover gallbladder enlargement splenomegaly enlargement or tenderness of kidneys identify aortic pulsations deep abdominal masses
soft, low-pitched sound that is continuous and may be heard epigastric & around the umbilicus
venous hum
midsternal liver span
4-8 cm
midclavicular vertical liver span
6-12 cm
dullness from L ribs 6-10
spleen
inflamed gallbladder pain with examination that abruptly halts inspiration
Murphy sign
pain or distress in the area of the patient’s heart or stomach on palpation of the McBurney’s point; associated with appendicitis
Aaron sign
fixed dullness to percussion on the left flank & dullness on the right flank that disappears with change in position; associated with peritoneal irritation
Ballance sign
rebound tenderness associated with peritoneal irritation or appendicitis
Blumberg sign
ecchymosis around umbilicus associated with pancreatitis, hemoperitoneum, pregnancy
Cullen sign
absence of bowel sounds in RLQ associated with intussusception
Dance sign
Which kidney is more palpable?
right
prominent lateral pulsation of the abdominal aorta
aortic aneurysm
What can be felt easily in a patient with ascites?
fluid wave
rebound tenderness over RLQ that suggests appendicitis
McBurney sign
pain related to intercourse or menses
uterine fibroids
burning abdominal pain
peptic ulcer
colicky pain
appendicitis; renal stone
Ecchymosis of flanks associated with pancreatitis
Grey Turner sign
abdominal pain radiating to left shoulder associated with splenic rupture
Kehr sign
RLQ pain intensified by LLQ palpation associated with appendicitis
Rovsing
examine conjunctiva to evaluate
pallor = anemia
examine the sclerae for
jaundice = hyperbilirubinemia
perianal tags are common with
Crohn’s disease
Cobblestone mucosa on colonoscopy
associated with sclerosing cholangitis and bloody, frequent watery diarrhea
UC
