refresher abdominal exam Flashcards
listen for bruits with ___ of stethoscope
bell
normal width of aorta and location for palpate
pulsation should be in what direction?
2-3 cm
just above umbilicus slightly left of midline
anterior inferior
abnormal bowel sounds
high pitches, decreased/absent
pancreas symp
T5-11
tympany found in
majority of abdomen, caused by air filled viscera
sympathetics for esophagus
T2-8
normal amt of bowel sounds
5-34 clicks or gurgles per min
ecchymosis around umbillicus secondary to hemorrhage
cullen sign
rebound tenderness or pain 1/3 of distance from ASIS to umbilicus may suggest ___
mcburney;s pt
appendicitis or periotneal irritation
rebound tenderness tests for
peritoneal inflammation
expected spleen span
from ribs 6-10 at mid axillary line on left
symp for SI
T9-11
symp for colon
T10-L2
obturator m test
flex pt right thigh at hip with knee bent then rotate leg interanally at the hip
right hypogastric pain is positive
suggests irriation of obturator m from inflammed appendix
appendix symp
T12
flank ecchymosis secondary to hemorrhage
grey turner sign
iliopsoas m test
have pt flex hip against resistance, increased abdominal pain = positive test
irritation of psoas m from inflammation of appendix
symp for stomach
T5-9
light palpation depth
mod
deep
light = 1 cm med = 2-3 cm deep = more than 3 cm
symp for GB
T6-9
symp for liver
T6-9
doc hand to palpate kidney
behind pt just below and parallel to 12th rib and press anterior
dullness
flat sound without echoes, heard over solid organs like liver and spleen
also fluid in the periotneum or feces give dull note
expected liver span
6-12 cm at mid clavicular line on right
courvoisier’s sign
enlarged non tender GB secondary to pancreatic disease or cancer
rovsing’s sing
pain in RLQ on left sided pressure
appendicitis
