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Clinical Medicine I > Phys Dx: Abdominal Exam > Flashcards

Phys Dx: Abdominal Exam Flashcards

1
Q

When performing ROS for abdominal issues, what other systems should you include?

A

1 above, 1 below

cardiopulm

GU

GYN

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2
Q

a GI patient writhing in pain can indicate…

A

stone

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3
Q

a GI patient who is lying motionless to avoid pain may indicate…

A

peritonitis

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4
Q

protuberant abdomen and umbilicus

bulging flank

areas of tympany and dullness

This may indicate…

A

ascites, fluid in peritoneal cavity

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5
Q

bulging at the umbilicus often when coughing…

this indicates

A

umbilical hernia

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6
Q

most common post-op

bulging near previous incision site

A

incisional hernia

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7
Q

Midline ridge, obvious with neck flexion

separation of rectus abdominus muscles

A

Diastasis recti

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8
Q

an increase of peristaltic waves may indicate…

A

intestinal obstruction

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9
Q

abdominal ecchymosis is indicative of…

A

intraperitoneal/retroperitoneal hemorrhage

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10
Q

vertical striae on the abdomen can indicate…

A

cushings

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11
Q

prominent abdominal veins suggests…

A

portal hypertension and cirrhosis

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12
Q

Splenomegaly

esophageal varices

ascites

hepatic encephalopathy

These are all signs of…

A

cirrhosis of the liver

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13
Q

normal frequency for bowel sounds…

A

5-34/min

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14
Q

normal bowel sound character…

A

clicks and gurgles

borborygmi (stomach growling)

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15
Q

Altered/abnormal bowel sound character

A

high pitched tinkling

hyper/hypoactive

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16
Q

high pitched, tinkling bowel sounds can indicate…

A

early intestinal obstruction

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17
Q

hyperactive bowel sounds can indicate

A

early peritonitis

diarrhea/gastroenteritis

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18
Q

absent bowel sounds are concerning for…

A

ileus (ilium obstruction)

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19
Q

hyperactive bowel sounds progressing to hypoactive is concerning for…

A

peritonitis

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20
Q

4 common areas for bruits in abdominal exam…

A

aorta

renal arteries

iliac arteries

femoral arteries

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21
Q

a distended abdomen that is tympanic to percussion throughout is suggestive of

A

intestinal obstruction or paralytic ileus

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22
Q

protuberant abdomen w/ bulging flanks and dullness is suggestive of…

A

ascites

23
Q

cirrhosis

hepatitis

alcoholic liver disease

abscess

hepatic tumor/cysts

hereditary condition

biliary disease

heart failure.

These are common causes of…

A

hepatomegaly

24
Q

when the speen enlarges, where does it expand?

A

anterior, downward, medial

25
Q

at what volume does dullness appear in the bladder?

A

400-600mL

26
Q

TTP of the bladder may indicate

A

cystitis

27
Q

is the bladder usually palpable?

A

no

28
Q

distension of the bladder, ability to be palpated, indicates

A

urethral stricture, prostatic hyperplasia, neurogenic bladder

29
Q

light palpation is assessing for

A

tenderness, guarding, rigidity

30
Q

voluntary contraction of the abdominal wall to with palpation…

A

guarding

31
Q

involuntary reflex contraction of abdominal wall muscles persistent over several examinations…

A

rigidity

32
Q

purpose of deep palpation is to…

A

delineate pain

identify masses and organs

palpation of liver and spleen in respiratory cycle

33
Q

A physiologic mass to deep abdominal palpation is…

A

pregnant uterus

34
Q

an inflammatory mass on deep abdominal palpation is…

A

diverticulitis

35
Q

a vascular mass on deep abdominal palpation is

A

AAA

36
Q

an obstructive mass on deep abdominal palpation is

A

distended bladder or dilated loop of bowel

37
Q

RUQ pain

radiates to right scapula

(+) murphy’s sign

A

acute cholecystitis

38
Q

epigastric pain

radiates to back

boring pain, drill-like pain

A

acute pancreatitis

39
Q

pain begins at umbilicus

migration to RLQ

(+) psoas, obturator, rovsing sign

A

acute appendicitis

40
Q

LLQ pain

A

acute diverticulitis

41
Q

(+) costovertebral angle tenderness

wraps from mid back to lateral abdomen

A

acute pylonephritis

42
Q

acute, severe colicky flank pain

radiates to groin

A

nephrolithiasis

43
Q

explosive, excruciating abdominal pain is concerning for…

A

biliary or renal colic

ruptured aneurysm or viscus

coronary occlusion

44
Q

abnormal liver presentation

A

firmness

blunt edge

surface irregularity

45
Q

congestive diseases (portal HTN, HF, splenic vein thrombosis

hematologic malignancies

Infx

These can cause…

A

splenomegaly

46
Q

kidney enlargement is suggestive of…

A

hydronephrosis

cysts/tumors

polycystic kidney disease

47
Q

an aorta of < _____ is normal

A

3cm

48
Q

focal dilation of the aorta > 3 cm

men

over 65

hx of tobacco use

this is concerning for…

A

AAA

49
Q

(+) Rebound tenderness, Guarding, Rigidity

may indicate…

A

peritoneal irritation

50
Q

(+) Rovsing, psoas, obturator

may indicate

A

peritoneal irritation with suspected appendicitis

51
Q

(+) Shifting dullness and fluid wave

may indicate…

A

ascites

52
Q

(+) murphy sign

may indicate…

A

cholecystitis

53
Q

(+) CVA tenderness

may indicate

A

kidney inflammation/pylonephritis

Clinical Medicine I (25 decks)

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