Physical Exam Flashcards
What are some pertinent family history questions to ask for GI patients?
- Peritonitis
- Gallbladder or kidney disease
- malabsorption syndrome
- hirschprung disease
- polypsis
- colon cancer
Should the patient urinate before the physical exam?
yes
What side should you approach the patient.
Right side
When you have the patient raise his/her head what will contract and what could it reveal?
The rectus will contract and can reveal diastasic recti, hernias, or certain masses.
What does blueish periumbilical discoloration suggest?
Its Cullen sign, suggests intraabdominal bleeding.
What is Gray-Turner sign?
Bluish flank discoloration \that suggests retroperitoneal or intraabdominal bleeding
What might asymmetrical distention indicate?
Hernia, tumor, cysts, bowel obstruction, or enlargement of abdominal organs
Describe bowel sounds and the rate they should occur.
Heard as clicks and gurgles that occur irregularly and range from 5-35 per minute.
What are long prolonged gurgles?
Borborygmi
What do high pitched, tinkling sounds suggest?
Intestinal fluid and air under pressure
To determine the boarders of the spleen, where do you percuss?
Posterior to the midaxillary line on the left side at the inferior costal boarder.
What is ascites?
Excessive intraabdominal fluid build-up
Rebound tenderness over McBurney’s point suggests what?
Appendicitis
What is Rovsing sign and when would you look for it?
Assess for Rovsing sign when concerned for appendicitis. A
positive test is increased right lower quadrant pain with palpation of the left lower
quadrant.
What is Iliopsoas sign and when would you look for it?
Conduct the Iliopsoas muscle test when you suspect
appendicitis. Have the patient lie supine and place your hand over the lower right
thigh. Have the patient raise the right leg while you push downward. Abdominal
pain with this motion is considered a positive “psoas sign”.
