Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Health Assessment > Quiz 2- Abdomen > Flashcards

Quiz 2- Abdomen Flashcards

1
Q

musculature of abdomen

A

4 layers of large flat muscle form ventral wall

can lead to low back pain when weak

helps with stabilization and movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

viscera of abdomen

A

SOLID ORGANS- maintain shape- liver, pancreas, spleen, adrenal, kidneys, ovaries, uterus (technically hollow but doesn’t change shape unless pregnant); some are PALPABLE

HOLLOW ORGANS- shape depends on content: stomach, gallbladder, small intestine, colon, bladder, usually NON-PALPABLE (unless colon with stool burden, distended bladder, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

quadrants of abdomen

A

RUQ- liver, gallbladder, head of pancreas, right kidney/adrenal gland, hepatic flexure of colon, part of ascending and transverse colon

LUQ- stomach, spleen, left lobe of liver (not always), body of pancreas, left kidney/adrenal, splenic flexure of colon, part of transverse/descending colon

RLQ- cecum, appendix, right ovary/fallopian tube, right ureter, right spermatic cord

LLQ- part of descending colon, sigmoid colon, left ovary/tube/ureter/spermatic cord

MIDLINE- aorta, uterus, bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

female abdominal pain AEIOU (not all inclusive)

A

appendix

ectopic pregnancy

inflammatory (PID)

ovarian-cyst/cancer

urinary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

epigastric pain

A

MI, peptic ulcer, acute cholecystitis, perforated esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

RUQ pain

A

acute cholecystitis, duodenal ulcer, congestive hepatomegaly, hepatitis, pyelonephritis, RLL pneumonia, early appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LUQ pain

A

ruptured spleen, gastric ulcer, aortic aneurism, perforated colon, LLL pneumonia, pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

RLQ pain

A

appendicitis, salpingitis, R ovarian abscess, ruptured ectopic, renal/uretic stone, diverticulitis, crohn’s, incarcerated hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

LLQ pain

A

intestinal obstruction, pancreatitis, sigmoid diverticulitis, early appendicitis, salpingitis, L ovarian abscess, ruptured ectopic, renal/uretic stone, diverticulitis, crohn’s incarcerated hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

examples of referred pain

A

cholecystitis- RUQ pain, referred straight back to below R scapula

pancreatitis- RUQ pain, referred to L shoulder/scapula area

renal colic- LUQ pain, referred to flank and mid back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

surgeries and their associations

A

esophageal resection- associated with fat malabsorption, abnormal swallowing, obstruction

stomach resection- associated with dumping syndrome, anemia, delayed emptying, malabsorption

small bowel resection- associated with steatorrhea, fat malabsorption, anemia, short gut syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cullen’s sign

A

intra abdominal bleed, bluish periumbilical color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

infant abdomen

A

rounded and protuberant

blood vessels and peristalsis more visible

DIASTASIS RECTI may be noted in normal infants, but check for any herniation

ABNORMAL- exaggerated “potbelly” appearance;may indicate malabsoprtion d/t celiac, CF, constipation, or aerophagia (ingestion of air; seen in infants with difficulty feeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

abnormal striae

A

prolonged stretching (pregnancy, cushing’s, obesity, ascites, tumors)

purple/dark red- cushing’s

white/red- pregnancy

shiny white-obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

abdominal pulsations

A

normal=aorta pulsation, possibly peristalsis with thin pts

abnormal- marked pulsation in aortic area (AAA, HTN)

visible peristalsis+distended abdomen=obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abdominal hair distribution

A

normal=diamond in males, triangle in females

abnormal=changes seen with endocrine disorder or hormone imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

sister mary joseph nodule

A

firm mass at umbilicus

if patients had this nodule-poor outcome from gastric CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

bowel sounds

A

normal= high pitched gurgling cascading sound; occurs irregularly 5-30 seconds

BORBORYGMUS- stomach growling, normal hyperactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

hyperactive bowel sounds

A

loud, high pitched, rushing, tinkling

indicates increased peristalsis

seen with EARLY OBSTRUCTION- hyperactivity in LUQ then absent in LLQ (below obstruction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

hypoactive bowel sounds

A

less frequent (longer than 30 seconds), quiet

seen after abdominal surgery, or with inflammation of peritoneum/paralytic ileus

SILENT ABDOMEN- must listen for 5 MINUTES (very uncommon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

vascular sounds in abdomen

A

important in patients with HTN- idenfity AAA, bruit, friction rub

NORMAL- no vascular sounds present

ABNORMAL- listen with bell or bruit: aorta, renal/iliac/femoral arteries

SYSTOLIC BRUIT- pulsating blowing sound heard with occlusion of an artery

FRICTION RUB- rare, indicates inflammation of peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

liver border: scratch test

A

place stethoscope over liver (lower costal margin, R MCL)

start in RLQ and scratch moving up toward liver

when scratching sound in stethoscope becomes magnified you have entered onto liver border (solid transmits sounds louder)

gross assessment of size, confirm with percussion/palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

bladder distention: scratch test

A

place stethoscope just above symphysis pubis, midline

scratch downward from umbilicus 1 cm, when sound intensified locates upper edge of bladder- full bladder produces sound of solid organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

purpose of abdominal percussion

A

assess density of abdominal contents, locate organs, look for abnormal fluid/masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

method of abdominal percussion

A

percuss lightly in all 4 quadrants, determine tympany vs. dullness

normal=tympany (high pitched d/t air)

abnormal= dullness over distended bladder, fat, stool, fluid or mass; hyperresonance with gaseous distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

liver span

A

start at MCL over lungs to percuss resonance, move down until dullness-mark this spot

start in RLQ at MCL to percuss tympany, move up until dullness- mark this spot

measure the distance- normal=6-12 cm; larger in taller perons M=5-10 cm, F=7cm

> liver span=HEPATOMEGALY

<6cm=ATROPHY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

spleen

A

percuss posterior MAL L side

have pt take a deep breath, percuss at last IC space in L MAL- should sound resonant

normal= should NOT be able to percuss spleen

abnormal= resonance of lungs changes to dullness (splenomegaly with mono, trauma, infection; poor technique; pt just ate)

28
Q

costovertebral angle tenderness

A

indirect first percussion causes tissues to vibrate

place hand over 12th rib at CVA, thump hand with ulnar edge of fist, assess both kidneys

normal=no pain

abnormal= pain (inflammation of kidney or paranephric area, renal stone)

29
Q

fluid wave

A

done to assess ascites seen with CHF, portal HTN, cirrhosis, hepatitis, pancreatitis, CA

place PTS HAND ulnar edge on midline abdomen, place YOUR HAND on R flank, tap L side

ABNORMAL= blow will generate fluid wave that is felt by hand on flank

if distended from gas or fat, you will feel no change

30
Q

shifting dullness

A

done to assess ascites, supine fluid settles by gravity into flanks

percuss top of abdomen to hear tympany (air), then percuss downside and it changes to dullness (fluid)- mark this spot

turn pt to side-percuss upper side of abdomen downwards until your hear dullness

ABNORMAL- fluid shifted with movement-ascites (spot where dullness is heard moves)

it will not detect <500 mL of fluid

31
Q

purpose of abdominal palpation

A

judge size/location/consistency of organs; screen for abnormal masses/tenderness

have pt lay on exam table with KNEES BENT (relaxes abdomen) and hands at the side

if area of tenderness-palpate last

LIGHT palpation- depress skin 1 cm with gentle rotary motion in all 4 quadrants assessing for muscle guarding, rigidty, large masses, and tenderness

DEEP palpation- press down 5-8 cm (2-3 inches), then small circle motion

32
Q

deep palpation of abdomen

A

move clockwise from RLQ to LLQ, imagining normal structures underneath

if pt is obese- BIMANUAL TECHNIQUE

NORMAL- xyphoid process, liver edge, muscle borders, cecum/ascending colon, sigmoid, full bladder (hollow organs will only feel if something inside- stool/urine)

ABNORMAL: tenderness occurs with local inflammation, inflammation of peritoneum/organ

33
Q

palpation of liver border

A

RUQ place hand under back at 11-12th rib

place right hand on RUQ, push deeply down and up under costal margin

have patient take a deep breath and push down and up under rib cage

normal= feel edge of liver bump your hand, firm/smooth, often non palpable too

abnormal= hard, nodular, tender, enlarged (extending down farther into RUQ)

34
Q

palpation of spleen

A

normally NOT PALPABLE- must be enlarged x3 to be felt

place one hand over LUQ under costal margin with fingers pointing towards L axilla, other hand underneath at 11-12th rib, turn pt slightly towards you

push down deeply while pt takes a deep breath

ABNORMAL= if enlarged, will feel firmness sliding under fingers

35
Q

child/infant spleen palpation

A

easily palpated/movable, soft with sharp edge

projects downward like a tongue under left costal margin, 1-2 cm

SPLENOMEGALY- would feel a larger amount; d/t infection, hemolytic anemia, infiltrative disorders, portal HTN, inflammatory/autoimmune diseases

36
Q

palpation of kidneys

A

RIGHT KIDNEY- one hand pressing upwards on right flank, other pressing deeply in RUQ, have pt take a deep breath

may feel round, smooth mass slide between fingers; may feel nothing

LEFT KIDNEY- not palpable

37
Q

palpation of aorta

A

palpate pulsation, SHOULD BE 2.5-4CM WIDE in adult

ABNORMAL= widened with aneurysm (>4cm)

38
Q

palpation of bladder

A

palpate a full bladder only

starting at umbilicus moving downward towards pubis

if maneuver elicits an URGE TO VOID- fundus is distended at that level

39
Q

abdominal wall tenderness

A

pain on palpation may arise from abdominal wall, parietal peritoneum, underlying viscera

AFTER FINDING AREA OF TENDERNESS, while abdomen is relaxed, keep hand over site, have patient sit up (arms crossed over chest) and apply pressure (CARNETT’S SIGN)

if tenderness on palpation is increased by tension of abdominal muscles (upon sitting up), pain originates from the abdominal wall= +ABDOMINAL WALL TENDERNESS

+AWT usually indicates ABSENCE OF INTRAABDOMINAL PATHOLOGY (not so in children/elderly/rigidity)

40
Q

+abdominal wall tenderness can be indicative of what?

A

muscular strain, viral myositis, fibrositis, nerve entrapment, trauma

41
Q

abdominal reflex

A

contraction of abdominal muscles and DEVIATION OF UMBILICUS TOWARDS STIMULUS

with pen/reflex hammer/nail- start at umbilicus and lightly scratch outwards (4 directions)

can be helpful in determining SPINAL LESION (if absent); obesity may interfere with response

42
Q

rebound tenderness (mcburney’s point)

A

pain that increases upon release of deep palpation

associated with peritoneal inflammation

apply several seconds of pressure at point (RLQ) and quickly release

PAIN= +MCBURNEY’S associated with appendicitis

43
Q

rovsing’s sign

A

associated with peritoneal inflammation

same maneuver but apply pressure to LLQ, pain felt upon release in RLQ

PAIN IN RLQ= +ROVSINGS associated with appendicitis

44
Q

murphy’s sign

A

seen with cholecystitis (sonographic murphy’s)

palpate during inspiration at liver margin; assess for RESPIRATORY ARREST (pt stops breathing/grasps when gallbladder presses against fingers)

PAIN WITH INSPIRATION = +MURPHY’S

45
Q

iliopsoas muscle test

A

associated with peritoneal irriation/appendicitis

irritation of the underlying lateral iliopsoas muscles (located close to appendix)

place hand on right thigh and push down as patient raises leg- creates resistance/flexion

PAIN IN RLQ= +ILIOPSOAS associated with inflamed appendix

46
Q

obturator test

A

associated with ruptured appendix or pelvic abscess

irritation of the obturator internus muscle (located close to appendix)

flex right leg at hip and knee, rotate leg internally and externally

PAIN IN HYPOGRASTRIC AREA (RLQ or R lower back)= + OBTURATOR SIGN

47
Q

signs of peritoneal irritation

A

tenderness to palpation, rebound tenderness, cough tenderness, guarding, involuntary guarding, rigidity

48
Q

risk factors for colorectal CA

A

older age, men>women, AA, jews of eastern european descendent (ashkenazi) highest risk

LIFESTYLE- obesity, inactivity, smoking, ETOH, diet high in red/processed meats, lower fiber diet, frying/grilling/cooking at high heat

PERSONAL HX- ovarian/endometrial/breast cancer, IBD (UC, crohn’s), IBS, T2DM

STRONG FAMILY HISTORY- colon CA or polyps in one first-degree relative dx at 55 or younger, or two first- degree relatives dx at any age, genetic disease (FAP, HNPCC)

49
Q

colon CA

A

3rd leading cause of cancer related death in the US

incidence increasing but mortality decreasing

SURVIVAL RATE R/T STAGE OF DISEASE AT DIAGNOSIS- overall 5 year survival- 65%, with bowel wall only- 91% with regional involvement- 72% with metastasis- 15%

WARNING SIGNS- anemia, rectal bleeding (black/dark stools), change in bowel habits, narrowing of stools, persistent abdominal discomfort (cramping, gas, pain, bloating), unexplained weight loss, weakness/fatigue, N/V

50
Q

american cancer society recommendations for colon CA

A

AVERAGE RISK:
screening every year from age 45-75 yo

can be STOOL-BASED TEST (cologuard) or through COLONOSCOPY

51
Q

CDC recommendation for colon CA

A

AVERAGE RISK: screening from age 45-75 yo

TESTED EARLIER IF:
close relative has had colorectal polyps or colorectal cancer

IBD such as crohn’s disease or ulcerative colitis

genetic syndromes such as familial adenomatous polypsosis (FAP) or hereditary non-polyposis colorectal cancer (lynch synrome, HNPCC)

VAST MAJORITY OF NEW CASES OF COLORECTAL CANCER (ABOUT 90%) OCCUR IN PEOPLE WHO ARE 50 AND OLDER

52
Q

positive family hx for colon cancer, screening options

A

CHOOSE ONE OF THE FOLLOWING:

colonoscopy every 5 years

double contrast barium enema every 3-5 years

at age 40 or 10 years before cancer was diagnosed in the youngest affects family member, whichever is earlier

53
Q

familial adenomatous polyposis

A

flexible sigmoidoscopy or colonoscopy YEARLY

STARTING AT AGE 10-12

genetic counseling- if + consider removal of colon

54
Q

lynch syndrome (3-5% of cancers)

A

hereditary non-polyposis colon cancer (HNPCC)

AGE 20-25 or 10 years before youngest case in family

colonoscopy every 1-2 YEARS

consider genetic counseling

55
Q

IBD (ulcerative colitis and crohn’s) screening for colon cancer

A

colonoscopy with biopsies for dysplasia every 1-2 YEARS

7-8 YEARS after DIAGNOSIS OF PANCOLITIS

12-15 YEARS after DIAGNOSIS OF LEFT SIDED COLITIS

56
Q

as you approach lou with a c/o abdominal pain, you recall that the proper order of assessing the abdomen is:

A

inspection, auscultation, percussion, palpation

57
Q

as you are assessing the abdomen, you notice purple/blue striae. you suspect…

A

cushing’s

58
Q

during a routine history and physical, you note thin, spoon shaped nails. you would want to order a…

A

CBC

indication of anemia

59
Q

mary’s physical examination is unremarkable except for RUQ tenderness and positive murphy’s sign. which of the following would you most likely suspect?

A

cholecystitis

60
Q

upon palpation of the abdomen, you elicit pain on RLQ by palpation of LLQ. this would be what?

A

roving’s

61
Q

the american cancer society recommends a sigmoidoscopy for colon cancer screening in persons at average risk how often?

A

age 45 for 2 years then every 3-5 years dependent on risk

person with a +family history is not at average risk

62
Q

in which patient would a slight pulsation in the epigastric area be expected?

A

a very thin patient

63
Q

while examining the abdomen, you stroke each quadrant of the abdomen lightly with a cotton tipped swab or the end of a reflex hammer, moving outward from the umbilicus. what does this cause?

A

contraction of the abdominal muscles and pulling of the umbilicus toward the stroked side

reflex toward the stimulus

64
Q

you note that the span of the patient’s liver is 18 cm. on palpation, the liver is enlarged, soft, and tender, suggesting…

A

hepatitis

65
Q

you observe a proliferation of superficial veins over the abdomen and upper chest of a patient, suggesting:

A

portal hypertension

Advanced Health Assessment (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions