Physical Examination of the Abdomen

Question 1

Sequence of the abdominal examination:

Answer 1

inspection, auscultation, percussion, and palpation

Question 2

Some preparation and positioning of patient prior to an abdominal exam:

Answer 2

empty bladder
approach from right sid e
supine, with pillow, knees slightly flexed 
good lighting
towel for privacy and warmth

Question 3

Why have the patient raise head off table during inspection of the abdomen?

Answer 3

will contract rectus abdominis, showing signs of separation indicative of diastasis recti, hernia, or certain masses.

Question 4

What should you note upon inspection of abdomen?

Answer 4

contour, color, symmetry, and surface motion of abdomen.

Question 5

what is the name for bluish periumbilical discoloration?

Answer 5

cullens sign

Question 6

what does Cullens sign suggest?

Answer 6

intraabdominal bleeding

Question 7

What is bluish flank discoloration called?

Answer 7

Gray-Turner sign

Question 8

what does Gray Turner signs suggest?

Answer 8

retroperitoneal or intraabdominal bleeding

Question 9

Purplish Striae are indicative of what?

Answer 9

Cushings disease.

Question 10

asymmetrical distention is indicative of what?

Answer 10

hernia, tumors, cysts, obstructions, enlarged abdominal organs.

Question 11

What are the vascular signs we listen to with auscultation?

Answer 11

bruits, friction rubs, venous hums.

Question 12

frequency of bowel sounds

Answer 12

5-35 per minute

Question 13

how long must you listen to bowel sounds?

Answer 13

5 min

Question 14

what is a name for loud prolonged gurgles?

Answer 14

borborygmi

Question 15

what will intestinal fluid and air under pressure sound like?

Answer 15

high pitched tinkling…. as in early obstruction.

Question 16

what sounds do you auscultate with the bell?

Answer 16

venous hums (epigastric region and around umbilicus) , bruits (on aortic, renal, iliac, and femoral arteries)

Question 17

Order of percussion:

Answer 17

overall first, examine tender/painful areas last.

Question 18

what is the palpation technique used to assess a floating mass?

Answer 18

ballottement

Question 19

what is the test called that is positive with increased right lower quadrant pain with palpation of the left lower quadrant?

Answer 19

Rovsing signs

Question 20

what is the test with a positive test is illicited with the removal of your hand?

Answer 20

Rebound tenderness

Question 21

what is a positive rebound tenderness test called?

Answer 21

positive blumbergs sign

Question 22

where is the point in the right lower quadrant suggesting appendicitis?

Answer 22

Mcburneys. (approx 2 inches from Anterior Superior Iliac Spine, on a straight line to the umbilicus

Question 23

what is the test that assesses for peritoneal irritation by striking heel?

Answer 23

Markle (heel jar) test

Question 24

This test you have the patient raise the right leg while you push downward, tests for appendicitis:

Answer 24

Iliopsoas Muscle Test

Question 25

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.

Answer 25

obturator muscle test

Question 26

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.

Answer 26

Murphy’s sign