Physical Examination of the Abdomen Flashcards
Sequence of the abdominal examination:
inspection, auscultation, percussion, and palpation
Some preparation and positioning of patient prior to an abdominal exam:
empty bladder approach from right sid e supine, with pillow, knees slightly flexed good lighting towel for privacy and warmth
Why have the patient raise head off table during inspection of the abdomen?
will contract rectus abdominis, showing signs of separation indicative of diastasis recti, hernia, or certain masses.
What should you note upon inspection of abdomen?
contour, color, symmetry, and surface motion of abdomen.
what is the name for bluish periumbilical discoloration?
cullens sign
what does Cullens sign suggest?
intraabdominal bleeding
What is bluish flank discoloration called?
Gray-Turner sign
what does Gray Turner signs suggest?
retroperitoneal or intraabdominal bleeding
Purplish Striae are indicative of what?
Cushings disease.
asymmetrical distention is indicative of what?
hernia, tumors, cysts, obstructions, enlarged abdominal organs.
What are the vascular signs we listen to with auscultation?
bruits, friction rubs, venous hums.
frequency of bowel sounds
5-35 per minute
how long must you listen to bowel sounds?
5 min
what is a name for loud prolonged gurgles?
borborygmi
what will intestinal fluid and air under pressure sound like?
high pitched tinkling…. as in early obstruction.
what sounds do you auscultate with the bell?
venous hums (epigastric region and around umbilicus) , bruits (on aortic, renal, iliac, and femoral arteries)
Order of percussion:
overall first, examine tender/painful areas last.
what is the palpation technique used to assess a floating mass?
ballottement
what is the test called that is positive with increased right lower quadrant pain with palpation of the left lower quadrant?
Rovsing signs
what is the test with a positive test is illicited with the removal of your hand?
Rebound tenderness
what is a positive rebound tenderness test called?
positive blumbergs sign
where is the point in the right lower quadrant suggesting appendicitis?
Mcburneys. (approx 2 inches from Anterior Superior Iliac Spine, on a straight line to the umbilicus
what is the test that assesses for peritoneal irritation by striking heel?
Markle (heel jar) test
This test you have the patient raise the right leg while you push downward, tests for appendicitis:
Iliopsoas Muscle Test
You perform this test when you suspect appendicitis or pelvic abscess. Flexing the right hip and knee to 90 degrees, rotating leg laterally and medially.
obturator muscle test
This test is when you place hands at the inferior costal margin in the right upper quadrant. Abrupt cessation of inspiration on palpation is suggestive of cholecystitis.
Murphy’s sign
