Lab Handout-Abdominal Exam

Question 1

correct order for abdominal exam?

Answer 1

Inspect–> auscultate –> percuss –> palpate

Question 2

__=flank ecchymosis secondary to hemorrhage

Answer 2

grey turner sign

Question 3

__=ecchymosis around umbilicus (periumbilical) secondary to hemorrhage

Answer 3

cullen sign

Question 4

normal amount of clicks heard when auscultating bowel sounds? abnormal?

Answer 4

normal=5-34

abnormal=high pitched, decreased/absent

Question 5

part of stethoscope to listen for bruits?

Answer 5

bell

Question 6

where/when would you hear dullness to percussion?

Answer 6

solid organs=liver and spleen

fluid in peritoneum or feces give dull note

Question 7

expected liver span?

Answer 7

6-12 cm at midclavicular line

Question 8

expected spleen span?

Answer 8

from ribs 6-10 at mid-axillary line on left

Question 9

__=pain upon removal of pressure, rather than the application of pressure to abdomen. tests for peritoneal inflammtion

Answer 9

rebound tenderness

Question 10

__=pain in RLQ during left-sided pressure

Answer 10

Rovsings sign

referred rebound tenderness seen in appendicitis

Question 11

__=rebound tenderness or pain 1/3 from ASIS to umbilicus

Answer 11

McBurneys

may suggest appendicitis/peritoneal inflamm

Question 12

positive murphy sign may indicate __

Answer 12

acute cholecystitis or cholelithiasis

Question 13

positive Courvoisier’s sign may indicate __

Answer 13

enlarged non-tender GB secondary to pancreatic disease or CA

Question 14

Sympathetic levels:
Esophagus=__
Stomach=__
Liver=__

Answer 14

esophagus=T2-8
stomach=T5-9
Liver=T6-9

Question 15

Sympathetic levels:
GB=\_\_
SI=\_\_
Colon=\_\_
Pancreas=\_\_
Appendix=\_\_

Answer 15

GB=T6-9
SI=T9-11
Colon=T10-L2
Pancreas=T5-11
Appendix=T12

Question 16

Parasympathetic levels:
Upper portion, esophagus thru transverse colon=__
Lower portion, desc colon, sigmoid, rectum=__

Answer 16

Upper=OA, AA (Vagus n)

Lower=S2-4 (pelvic splanchnic n.)

Question 17

You flex a pts hip against your resistance and they report abdominal pain. What does it suggest?

Answer 17

irritation of psoas muscle from inflam of appendix

Iliopsoas muscle test

Question 18

You flex the pts right thigh at the hip with the knee bent and rotate the leg internally at the hip. They report pain in the right hypogastric region. Suggests?

Answer 18

irritation from obturator muscle from inflammed appendix

Obturator muscle test