PE of abdomen Flashcards
Suggest portal hypertension from
cirrhosis (caput medusa) or inferior vena cava obstruction.
dilated veins
Seen in intraperitoneal or
retroperitoneal hemorrhages
rashes or ecchymoses
bluish discoloration around
umbilicus
cullen’s sign
bluish discoloration around
the flanks
grey turner’s sign
The normal aortic pulsation is frequently visible
in the
epigastrium
They are formed
by turbulent flow of the blood through the vessels, and suggest vascular occlusive Disease.
Bruits
a high pitched musical sound that would
indicate a hollow space filled by air or gas in the GIT
tympany
fluid, underlying organs, masses, or
feces
dullness
Measure the vertical span of liver dullness in the
midclavicular line
Border of cardiac dullness at: the 6th rib, Anterior axillary line, Left costal margin
traube’s space
most inferior interspace on the left anterior axillary line
Castell’s sign
Normally cannot be examined unless it is distended
above the symphysis pubis.
bladder
Bladder volume must be _____ before
dullness appears.
400 to 600 ml
Involuntary rigidity typically persists despite
these maneuvers, suggesting ______
peritoneal inflammation
Inflammation of the parietal peritoneum
peritonitis
Signs of peritonitis
o Positive cough test o Guarding: voluntary contraction or involuntary o Rigidity – involuntary reflex contraction of the abdominal wall that persists over several VOLUNTARY VS INVOLUNTARY RIGIDITY examination o Rebound tenderness o Percussion tenderness
t or f
normal liver edge is soft,
sharp,and regular, with a smooth surface.
T
On inspiration, the liver is palpable about 3 cm below the
right costal margin in the midclavicular line.
Splenomegaly is eight times more likely when the
spleen is palpable. Causes include
o Portal hypertension
o Hematologic malignancies
o HIV infection
o Splenic infarct or hematoma
Kidney palpation
Below and parallel to 12th rib
Place the ball of one hand in the costovertebral angle and strike it with the ulnar surface of your
fist.
CVAT
CVAT: Pain with pressure or fist percussion suggests
pyelonephritis
normal aorta is not more than 3cm wide (average, 2.5 cm)
> 50 yo
Ascites reflects the \_\_\_\_\_\_\_\_\_\_ in cirrhosis (the most common cause of ascites), heart failure, constrictive pericarditis or inferior vena cava or hepatic vein obstruction.
inc hydrostatic pressure
dec osmotic pressure
nephrotic syndrome, malnutrition, ovarian cancer
Impulse transmitted
(+) fluid wave
is the most tender area in the
presence of acute appendicitis.
mcburney’s point
When right upper quadrant pain and tenderness
suggest acute cholecystitis, assess
murphy’s sign
the patient
stops breathing in and winces with a ‘catch in breath
(+) murphys sign
