PD - Abdominal exam Flashcards
abd surface anatomy
- Rectus abdominis muscle
- Umbilicus
- Inguinal ligament
- Costal margins
- Linea alba
- Iliac crest
- Anterior superior iliac spine (ASIS)
- Symphysis pubis
- McBurneys Point
LUQ
Liver, left lobe Spleen Stomach Pancreas: body Left adrenal gland Left kidney: upper pole Splenic flexure Transverse colon: portion Descending colon: portion
RUQ
Liver Gallbladder Pylorus Duodenum Pancreas: head Right adrenal gland Right kidney: upper pole Hepatic flexure Ascending colon: portion Transverse colon: portion
RLQ
Right kidney: lower pole Cecum Appendix Ascending colon: portion Right ovary Right fallopian tube Right ureter Right spermatic cord Uterus, Bladder (if enlarged)
LLQ
Left kidney: lower pole Sigmoid colon Descending colon: portion Left ovary Left fallopian tube Left ureter Left spermatic cord Uterus, Bladder (if enlarged)
Epigastrium
Stomach
Pancreas
Liver (portion)
Aorta
Suprapubic area
Bladder
Uterus
Imp sx for abd disease
Pain Nausea and vomiting Change in bowel movements GI bleeding Jaundice or Icterus Abdominal distention Mass Pruritis (itching)
To characterize abd pain, note…
time acuteness location severity character radiation
Right shoulder pain
referred from acute cholecystitis or anything irritating the right hemidiphragm
Testicular pain
referred from renal colic or appendicitis
Periodic epigastric pain 1 hour after eating-
think gastric peptic ulcer
Pain 2-3 hours after eating
think duodenal peptic ulcer
Back pain
perforation of duodenal ulcer, pancreatic pain
Nocturnal pain
duodenal peptic ulcer
Postprandial pain (after eating)
part of the abdominal angina triad, which also includes anorexia and weight loss.
Tenesmus
A feeling of needing to void the bowel, but unable to defecate
Causes of vomiting
severe irritation of the peritoneum resulting from perforation of an abdominal organ;
abdominal obstruction of the bile duct, ureter, or intestine;
inflammation of intraabdominal structures
extra-abd causes: cardiac ischemia, pregnancy, central nervous system disorders, medications, and drug toxicity
cause of episodic vomiting at height of pain
obstruction
causes of persistent vomiting
toxin, central nervous system causes, metabolic causes
Green-yellow vomitous cause
biliary colic
Feculent smelling vomitus cause
intestinal obstruction
causes of nausea w/o vomiting
hepatocellular disease, pregnancy, metabolic causes
Not all abd emergencies cause vomiting, exp…
intraperitoneal bleeding
bowel movement hx
duration number of movements per day onset whether or not change was associated with a meal the type of meal one ate, characterization, constipation, weight loss, caliber of stool, other symptoms it may be associated with
acute onset changes in bowel movements may be caused by
acute infection or toxin
causes of watery stool
small bowel and colon inflammation or protein-losing enteropathies
causes of bloody diarrhea
dysentery
causes of alternating diarrhea and constipation
colon cancer, diverticulitis, colitis
Floating, light colored, or foul-smelling stool
malabsorption syndrome
Stool mixed with blood and mucus
ulcerative colitis or Crohn’s colitis
Blood with stool or undigested food
inflammation of small bowel or colon
Pencil-thin stool
anal or distal rectal carcinoma
clay colored stool
obstruction of bile flow or decreased production of bile
Constipation and weight gain
hypothyroidism
Constipation and weight loss
colon cancer
Silver-colored stool
rare cancer of the ampulla of Vater in the duodenum