Prefinal - Unit C 1 Flashcards
is an increase in the amount of breast gland tissue in boys or men. An imbalance of the hormones estrogen and testosterone causes it
Gynecomastia
Gynecomastia Grading: Small enlargement without skin excess.
Grade I
Gynecomastia Grading: Moderate enlargement without skin excess.
Grade II
Gynecomastia Grading: Moderate enlargement with minor skin excess.
Grade III
Gynecomastia Grading: Marked enlargement with excess skin, mimicking female breast ptosis
Grade IV
Abdominal contour:
Flat
Scaphoid
Rounded
Protuberant
occurs when part of your insides bulges through an opening or weakness in the muscle or tissue that contains it. They mostly involve one of your abdominal organs pushing through one of the walls of your abdominal cavity
Hernia
Observe both sides for symmetry.
The abdomen does not bulge when the client raises their head.
This umbilicus lies at a vertical level corresponding to the junction between the L3 and L4 vertebrae, with a normal variation among people between the L3 and L5 vertebrae.
Abdominal pulsations can be seen if the client lies in dorsal recumbent, this is related to blood flowing through the abdominal aorta.
are swollen, twisted veins that lie just under the skin. They usually occur in the legs.
Varicose veins, or varicosities
Bowel sounds (borborygmi) are caused by peristaltic movements
Normal/Active bowel sounds are high-pitched gurgling noises. Approx 5-35 Sounds per minute, or at least 1 every 5-15 seconds.
Hypoactive Bowel Sounds - Often soft and widespread. Less than 5 BS per minute.
Absent No bowel sounds were heard. Must listen for 5 minutes before concluding that bowel sounds are absent
Causes of hypoactive abdominal sounds or the absence of bowel sounds are perforated ulcer, certain medications (such as codeine), damage of intestines, general anesthesia, abdominal surgery, infection of the abdominal cavity, or peritonitis.
Hyperactive Bowel Sounds - Loud, gurgling, frequent sounds. Greater than 35 BS a minute.
Inflammation of the bowel can be due to:
anxiety
diarrhea
bleeding
excessive ingestion of laxatives
rxn of intestines to certain foods
Loud stomach growling, rumbling sound produced by the movement of gas in the stomach and intestines. Heard with or without a stethoscope
Borborygmi
This supplies oxygenated blood to the abdominal, pelvic organs, and legs.
Abdominal aorta
This is the blood vessel that carries oxygenated blood to the kidneys.
Renal artery
This supplies blood to the pelvic region, hips, thighs & reproductive organs.
Iliac artery
This supplies the thigh and the main arterial supply to the thigh and leg.
Femoral artery
is a low-pitched, vascular sound, resembling murmur. It is caused by partially obstructed artery - turbulence.
Bruits
A venous continuous, hum (soft, and low-pitched) in the abdomen usually indicates ___.
increased portal tension
are caused by two organs rubbing together or by an organ rubbing against the peritoneum.
Friction rubs
A friction rub in the abdomen usually indicates a tumor, infection, infarct, or peritonitis and requires further medical evaluation.
Friction rubs are not normally heard.
Tympany is the normal sound heard over the abdomen.
An enlarged area of dullness is heard over an ___
enlarged liver.
A liver in a lower position than normal is significant in ___. A liver in a higher position is significant in the ___
emphysema
presence of mass, ascites, or paralyzed diaphragm.
If the nurse suspects ascites, perform the ___
shifting dullness or fluid wave tests.
The patient then is rolled on his/her side away from the examiner, and percussion from the umbilicus to the flank area is repeated. Positive test: When ascites is present, the area of dullness will shift to the dependent site. The area of the tympany will shift toward the top.
Shifting Dullness Test
Dullness that is not present during expiration but is present during inspiration should suggest the presence of an enlarged spleen that has descended with inspiration. In this case, palpation should be repeated to try to confirm this impression.
Splenic Dullness
used to detect spleen enlargement, is at the precordial area on the anterior wall of the chest. In this respect, correct assessment of this area during physical examination is very important. From the 6th rib downward.
Traube’s space
Dullness anterior of the midaxillary line indicates ___.
Caused by infections, cirrhosis, and other liver diseases, blood diseases characterized by abnormal blood cells, and lymph system problems.
Splenomegaly
In light palpation: Involuntary reflex guarding is significant and reflects peritoneal irritation. Right-sided guarding is indicative of cholecystitis, and inflammation of the gallbladder.
In deep palpation: Severe tenderness or pain may be related to trauma, peritonitis, infection, tumors, or enlarged or diseased organs.
The soft center of the umbilicus can be potential for herniation. Hard nodules in and around the umbilicus are significant in spreading nodes.
The normal aorta is 2.5 to 3.0 cm wide with strong and regular pulsation.
Methods of Liver Palpation:
Standard method
Hooking Technique
Dipping Method
___ method
* Patient must be supine with knees flexed.
* Ask the client to take a deep breath
* The nurse moves his hand from the right in the iliac fossa gradually upwards until you feel the edge of the liver
Standard
___ technique
- Stand at the patient’s shoulder and face the patient’s feet
- Hook fingers over the costal margins from above
- Patient to take a deep breath
- Feel for the liver edge to bump your fingertips during inhalation
Hooking
___ method
This method of palpation is Helpful in palpation of viscera in cases of massive ascites.:
- Placing the hand over the abdomen and making quick and gentle dipping movements (also known as one-hand ballottement)
- Also with bimanual ballottement
Dipping
swelling of a kidney due to a build-up of urine
Hydronephrosis
___ Test
- Ask the patient or assistant to press the edges of both hands firmly down on the midline of the abdomen.
- While you tap one flank sharply with your fingertips feel for a fluid pulse on the opposite flank with the other hand
- Movement of a fluid wave against the resting hand suggests large amounts of fluid are present (ascites).
Fluid Wave
is a test for ascites. It is performed by having the patient push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling the other flank for the tap
Fluid Wave Test
For identifying an organ or a mass in an ascitic abdomen.
- Straighten and stiffen the fingers of one hand together, place them on the abdominal surface, and make a brief jabbing movement directly toward the anticipated structure.
- This quick movement often displaces the fluid so that your fingertips can briefly touch the surface of the structure through the abdominal wall.
Ballotement
is the finding of right lower quadrant pain during palpation of the left side of the abdomen or when left-sided rebound tenderness is elicited.
Rovsing’s sign
means that there is more pain when pressure on the tender area is released. It occurs when the tissue that lines the abdominal cavity (the peritoneum) is irritated, inflamed, or infected
Rebound tenderness
Pain on passive internal rotation of the hip when the right knee is flexed. It is present when the inflamed appendix is in contact with the obturator internus muscle.
Obturator sign
