Table 11-10 Sounds in the Abdomen

Question 1

What are the different typs of sounds in the abdomen (4)

Answer 1

1. Bowel Sounds
2. Bruits
3. Venous Hum
4. Friction Rubs

Question 2

What are cause of incrased bowel sounds

Answer 2

diarrhea or early inestinal obstruction

Question 3

What causes decreased bowel sound

Answer 3

adynamic ileus and peritonitis

Question 4

What shoudl you do before deciding that bowel sounds are absent

Answer 4

Sit downa dn listen where shown for 2 minuts or longer

Question 5

What does a HEPATIC BRUIT suggest

Answer 5

carcinoma of the liver or alcoholic hepatitis

Question 6

What does Arterial Bruit with both systolic and diastolic components suggest

Answer 6

partial occlusion of the aorta or large arteries

Question 7

What can expalin hypertension

Answer 7

partial occuslion of a renal artery

Question 8

What is a Venous Hum. Is it rare? what causes it?

Answer 8

it is rare

It is a soft humming noicse with both systolic and diastolic components.

It indiacted increased collateral circulation between Portal and Systemic Venous Systemics, as in hepatic Cirrosis

Question 9

Where do you listen for Venous Hums?

Answer 9

Epigastric and Umbilical (towards right side where liver is)

Question 10

What are Friction rubs

Answer 10

Rare

Grating sounds with respiratory variation.

They indicate inflammation of the -peritoneal surface of an organ,

• as in liver cancer,
• chlamydial or gonoccoccol perihpeatitis, -recent liver biopsy or splenic infarc

Question 11

Abdominal wall Tenderness

What happens when patient reaises head and shoulders

Answer 11

Tenderness may originate in abdominal wall.

When pt raises head and shoulders, tenderness perissts, whereas tenderness from a deeper lesion (protecred by the tightened muslce_ decerases

Question 12

Visceral Tenderness

Answer 12

Enlarged liver, normal aorta, normal cecum, normal or spastic sigmoid colon may be tender to deep palpation

usually the discomfort is dull with no muscular rigidity or rebound tenderness

Reassuring explanation to teh pt may prove quite helfpuld

Question 13

What is acute Pleurisy

Answer 13

Abdominal pain and tenderness may result from acute pleural inflammation

When unilateral, it may mimic acute cholecystitis or appendicitis

Rebound tenderness and rigidity are less common

CHest signs are usually prsent

Question 14

Waht is acute Salpingitis

Answer 14

Frequently bilateral, tenderness of acute salpingutis (inflammation fo the fallopian tubes_ is usually maximal just above inguinal ligmaents

Rebound tenderness and rigitidy amy be present

On pelvic examination, motion of the uternus causes pain

Question 15

What is tenderness of Peritneal inflammation

Answer 15

Tenderness ass with peritoneal inflammation is MORE SEVERE than vsiceral tenderness

Muscular rigidity and rebound tenderness are frequently, but not necessarily prsent

Generaliezed peritonitis causes exquisite tenderness throughout the abdomen, teogether with boardlike muscular rigidity.

These signs on palpation, esp abdominal rigidity, doubl the likelihood of peritonitis.

Local causes of peritoneal inflammation

Question 16

Which is more severe: peritoneal inflammation or visceral tenderness

Answer 16

Peritoteanl Tenderness

Question 17

What are local causes of periteonal inflammation (4)

Answer 17

Acute Cholecystitis
Acute Pancreatitis
Acute Appendicitis
Acute Diverticulitis

Question 18

Where do you feel Acute Cholecystitis? What test?

Answer 18

Maximial in RUQ

CHeck for Murphy’s sign

Question 19

Where do you feel Acute Pancreatitis.

Answer 19

Epigastric Tenderness
Rebound Tenderness are usually present

Abdominal wall may be soft