Module 9: Abdomen Flashcards
1. Describe the gross anatomy of the gastrointestinal tract. 2. Describe the gross anatomy of the urinary tract. 3. Describe the techniques of examination of the abdomen. 4. Identify key abnormalities of the abdomen, liver, spleen, kidneys, bladder and aorta. 5. Identify pertinent information needed to obtain a focused history of conditions related to the abdomen and gastrointestinal system. 6. Describe the process of conducting a focused physical examination of clients presenting with cond
What are some different shapes of the abdomen?
Flat, scaphoid, distended, obese
When assessing the abdomen, what should you look for?
Shape, masses, bowel sounds, organomegaly, tenderness, inguinal nodes.
What are 3 terms used to help describe the abdomen?
Epigastric, umbilical, hypogastric (suprapubic)
What type of rotation should you move in when assessing the abdomen?
Clockwise
Where would you find the spleen?
Left upper quadrant.
Which ribs are responsible for protecting the spleen?
9th, 10th, and 11th
What can you expect to find in the right upper quadrant?
The liver, gallbladder, lower pole of right kidney.
What can often be felt in the left lower quadrant?
sigmoid colon.
Where would expect to find the bladder?
Lower midline.
What’s in the right lower quadrant?
Bowel loops and the appendix. In healthy people, there will be no palpable findings there.
The bladder accommodates roughly how much urine filtered by the kidneys?
300 mL
What makes you have the urge to pee?
Rising pressure in the bladder triggers the conscious urge to pee.
Which muscle is responsible for bladder contraction?
The detrusor muscle.
What helps to prevent incontinence?
Increased intraurethral pressure
Where do the kidneys lie?
Posteriorly.
What is the area to assess for kidney tenderness?
Costovertebral angle
What are some common complaints associated with GI disorders?
- Abd Pain, acute and chronic
- Indigestion, N/V, including blood, loss of appetite, early satiety.
- Dysphagia &/or odynophagia
- Diarrhea, constipation
- Jaundice
Common complaints associated with urinary and renal disorders?
- Suprapubic pain
- Dysuria, urgency, or frequency
- Hesitancy, decreased stream in males
- Polyuria or nocturia
- Urinary Incontinence
- Hematuria
- Kidney or flank pain
- Ureteral colic
What are common complaints associated with lower GI?
- Diarrhea
- Constipation
- Change in bowel habits
- Blood in the stool (bright red or dark tarry)
Visceral pain in the RUQ may result from liver distention against its capsule due in which disease?
Alcoholic Hepatitis
When hollow abdominal organs such as the intestine or biliary tree contract unusually forcefully or are distended or stretched results in what?
Visceral pain. Can be associated with sweating, pallor, nausea, vomiting, restlessness.
What is a sign of early acute appendicitis?
Visceral periumbilical pain. It eventually changes to parietal pain in the RLQ due to inflammation of the adjacent parietal peritoneum.
Where does parietal pain originate from?
the inflammation from the parietal peritoneum.
- It is described as a steady, aching pain that is usually more precisely located over the involved structure.
- aggravated by movement or coughing
- patient prefers to lie still.
Where is pain of duodenal or pancreatic origin referred to?
The back.
Pain felt in more distant sites, which are innervated at approximately the same spinal levels as the disordered structures.
Referred pain.
Why does referred pain develop?
The initial pain becomes more intense and radiates from the initial site.
What do neuropeptides like 5-hydroxytryptophan and substance P do?
Mediate interconnected symptoms of pain, bowel dysfunction, and stress.
A patient presents doubling over with cramping colicky pain, can radiate to the left or right lower quad, what is wrong?
Renal stone.
If a patient presents with sudden knifelike epigastric pain, what would suspect?
Gallstone pancreatitis.
What does RUQ and upper abdominal pain signify?
Cholecystitis
What deciphers angina from indigestion?
Precipitated by exertion and relieved by rest.
A subjective negative feeling that is non painful?
Discomfort.
What do you call swallowing air?
Aerophagia
Patients with chronic upper abdominal discomfort or pain complain primarily of what?
Heartburn, acid reflux, or regurgitation. Having these symptoms more than once a week, the patient is likely to have gastroesophageal reflux disease.
What are the risk factors for GERD:
- Reduced salivary flow, which prolongs acid clearance by damping action of the bicarbonate buffer.
- Delayed gastric emptying
- Selected Medications
- Hiatal hernia
What types of foods aggravate heartburn?
- Alcohol
- Chocolate
- Citrus fruits
- Coffee
- Onions
- Peppermint
What positions can aggravate heartburn?
- Bending over
- Exercising
- Lifting
- Lying supine
What are some other side effects of GERD?
Atypical Respiratory Symptoms
- Cough
- Wheezing
- Aspiration Pneumonia
Pharyngeal Symptoms
- Hoarseness
- Chronic sore throat
What are the “alarm symptoms” of GERD?
- Difficulty swallowing (dysphagia)
- Pain with swallowing (odyophagia)
- Recurrent vomiting
- Evidence of GI bleed
- Weight loss
- Anemia
- Risk factors for gastric cancer
If a patient is 55 yr or older and presents with those “alarm symptoms”, what should you do?
Endoscopy to help detect esophagitis, peptic strictures, or Barrett’s esophagus.
RLQ pain or pain that migrate from the periumbilical region, combined with abdominal wall rigidity on palpation.
Appendicitis. BUTTTTT in women, it could be pelvic inflammatory disease, ruptured ovarian follicle, and ectopic pregnancy.
What other symptoms are associated with left lower quad or diffuse abdominal pain?
Fever and loss of appetite. LLQ pain with a palpable mass may be diverticulitis.
Diffuse abdominal pain with absent bowel sounds and firmness, guarding, or recount on palpation may indicate what?
Small or large bowel obstruction.
What would a change in bowel habits with mass lesion indicate?
Colon Cancer.
Intermittent pain for 12 week of the preceding 12 months with relief from defecation, change in frequency of bowel movements, or change in form of stool (loose, watery, pellet-like), without structural or biochemical abnormalities.
Irritable bowel syndrome.
A general term for distress associated with eating that can have many meanings.
Indigestion.