Lecture 8.1 - Abdomen Flashcards
Which quadrant are the liver, gallbladder and hepatic flexure of the colon found in?
RUQ
Which quadrant is the pancreas found in?
The head of the pancreas is found in the RUQ, the body is in the LUQ.
Which quadrant is the duodenum found in?
RUQ
Which quadrant are the kidneys and adrenals found in?
In their corresponding upper quadrants
Which quadrant is the stomach found in?
LUQ
Which quadrant is the Spleen and splenic flexure of the colon found on?
LUQ
Which quadrant are the cecum and appendix found in?
RLQ
Which quadrants are the spermatic cords/ovaries and fallopian tubes found in?
Lower quadrant of corresponding side.
Which quadrant are the ureters found in?
Lower quadrant of corresponding side.
Which quadrant is the sigmoid colon found on?
LLQ
How does adipose tissue distribution change in older males an females?
Women have an increase in suprapubic adipose tissue and men have an increase in abdominal adipose tissue.
How does salivation, gastric secretion, the liver, and renal function change in older adults?
Decreased gastric acid and saliva production
Decreased liver size and renal function
Why are older adults at a higher risk for pneumonia?
Because they experience delayed esophageal emptying, which increases their chance of aspirating.
Aspiration often leads to pneumonia.
Why are older adults at risk of constipation?
Because they often do not feel at thirsty, and thus also experience higher rates of dehydration
Why are older adults at risk of toxicity due to drugs?
Liver atrophy with age means they cannot metabolize medication as quickly
What additional health history should obtain when doing a nutritional/abdominal assessment of an older adult?
Food access, emotional characteristics (eating alone or in company), recent food recall, bowel movements
What is pyrosis?
Heartburn
What is cholecystitis?
Inflammation of the gallbladder
What might hematemesis indicate?
Varices or ulcers
What is melena and what causes it?
Black stool with a tar-like consistency - indicates bleeding higher up in GI tract
What are abdominal adhesions and what might cause them?
fibrosis/scarring of the abdominal viscera - be aware of them in patients who have had GI/abdominal surgery
When examining the contour of a patients abdomen, how would a depressed shape be described?
Scaphoid
When examining the contour of a patients abdomen, how would a very large/extended shape be described?
Protuberant
Which four words are used to describe the shape and contour of an individual’s abdomen?
Flat
Scaphoid
Rounded
Protuberant
Which information should be noted when inspecting the umbilicus?
Colour
–> Should match surrounding skin
Position
–> Along midline
Orientation
–> Usually inverted
–> Everted is normal for some people, but be sure to ask the patient
Are visible veins normal on the abdomen?
No, abnormal findings
What is skin turgor? How can it be tested for?
The skin’s ability to stretch an return back to normal
Pinching a small area of skin - if it returns to normal quickly, it has high turgor
What is the normal size for striae?
Between 1-6 cm
Are striae normal?
They are for the vast majority of individuals. Always ensure to ask about new findings, the patient can confirm if they are normal for them or not.
What is a percutaneous endoscopic gastrostomy?
A feeding tube that goes through a stoma in the stomach.
What are normal bowel sounds? Which side of the stethoscope should be used to listen to them?
Diaphragm of stethoscope is best
–> High-pitched, gurgling, cascading sounds that is irregular in rhythm
–> Normally 5-30 sounds/min
What are normal abdominal vascular sounds? Which end of the stethoscope should you listen to them with?
Listen with Bell
–> No normal vascular sounds
Which technique should be used to listen to abdominal sounds?
Begin in RLQ (or area of least tenderness) and work clockwise
What are normal and abnormal causes for
hyperactive bowel sounds?
Normal:
–> Empty stomach
Abnormal
–> Early-stage bowel obstruction
How would you assess for hypoactive or absent bowel sounds? What might cause this?
Decreased or absence of bowel sounds - listen for full five minutes to assess
Post-abdominal surgery, inflammation of peritoneum, late-stage bowel obstruction
What might cause systolic bruit in the abdomen?
AAA, partial occlusion of femoral arteries, renal artery stenosis (Depending on area you’re listening to)
What does abdominal venous hum sound like? What might cause it?
Soft, continuous humming noise of medium pitch
Caused by portal HTN, liver cirrhosis.
Where would tympany be heard over viscera?
Over hollow organs
Where would dullness be heard over viscera?
Over solid organs (or an abnormal mass or fluid)
What is involuntary rigidity associated with?
Peritonitis
What might cause ascites?
Liver cirrhosis, CHF, Cancer
What is a major concern for someone with a bowel obstruction?
Hypovolemic shock due to dehydration and loss of electrolytes
What is Colicky pain?
Intense, sharp pain due to strong peristaltic contractions.
A bowel obstruction leads to excess fluid and gas buildup, what might this cause?
Fluid leakage into peritoneum.
What temperature would you expect in a person experiencing chronic liver disease?
Lower temperature due to chronic vasodilation caused by liver disease
How does the prostate change in older adults? Why?
Hormonal imbalances cause benign adenoma formation - prostate hypertrophy can mechanically obstruct urethra
What is dyschezia
Pain while passing stool
When are black stools normal?
When the patient is taking iron supplements
Hemorrhoids are varicose veins on the anus caused by increased portal venous pressure.
What might cause increase portal venous pressure?
Chronic constipation, liver disease, pregnancy
What are some symptoms of external hemorrhoids?
Pain, pruritis, bleeding during defecation.
Thromboses contain clotted blood, they are often swollen, shiny, blue
How can Internal hemorrhoids be observed?
Red mucosal mass, often seen during the Valsalva maneuver.
What might cause fecal impaction?
Decreased bowel mobility and low-fiber diet
What are the symptoms of a fecal impaction?
Pain, bloating, anorexia, urgency to pass stool but inability to do so, overflow incontinence.
Which patient would you want to assess first?
1. Patient who has had diarrhea for 2 days
2. Patient who states their hemorrhoids are causing pain
3. Patient who has not passed stool in two days
4. Patient who has melena while on ion supplements
- Diarrhea for two days
This person is dehydrated and experiencing an electrolyte imbalance.
What is amenorrhea?
The absence of a period during reproductive years
