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ClinMed II > Test 2: Abdominal Assessment > Flashcards

Test 2: Abdominal Assessment Flashcards

1
Q

Abdominal assessment consists of what components

A

preparation and positioning
observation
auscultation
percussion
palpation
neuro tests

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2
Q

prep/positioning for abdominal assessment

A

empty bladder

supine with UEs at side

stand at patients R side

be able to view pt facial expression

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3
Q

what are the 2 quadrants above and below the umbilical middle quadrant referred to as

A

above = epigastric

below = hypogastric

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4
Q

what is in the LUQ

A

spleen
stomach
aorta
pancreas
transverse colon

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5
Q

what is in the RUQ

A

liver
gallbladder
R kidney
duodenum

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6
Q

what is in the RLQ

A

ascending colon
iliac artery
cecum
appendix
bladder

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7
Q

what is in the LLQ

A

descending colon
sigmoid colon
bladder

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8
Q

what asymmetries might you find with observation

A

surface contour= distension could be bowel obstruction, mass, etc

swelling or ascites = possibly indicated by inverted umbilicis

umbilicis should be midline

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9
Q

discoloration may indicate

A

jaundice with liver dysfunction

ecchymosis indicating bleeding

vein distension indicating liver or vena cava obstruction

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10
Q

marking you may look for

A

scars
rashes
stretch marks

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11
Q

pulsatile mass may indicate

A

abdominal aortic aneurysm

not unusual on lean individuals though

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12
Q

what is peristalsis

A

wavelike motion that may indicate intestinal obstruction

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13
Q

what might indicate a hernia

A

sudden bulging with lifting head or a cough could indicate hernia

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14
Q

when/how long to perform auscultations

A

perform before percussion and palpation to avoid altering the bowel sounds

utilize stethescope for 2 min in each quadrant

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15
Q

what is normal and abnormal for bowel sounds

A

normal = high pitch clicks and gurgling every 5-10 sec

abnormal= non indicating bowel obstruction, particularly with cramping OR more sounds may indicate overactivity like with lactose intolerance

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16
Q

what are you listening for/where is the abdominal aorta

A

just L of midline and umbilicus at peri sternal line

bruits indicate turbulent blood flow

17
Q

what is the procedure for percussions

A

hyperextend and apply firm pressure with non-dominant and distal aspect of middle finger

avoid contact anywhere else

position dominannt hand close to surface with extended wrist

strick non-dominant middle finger with flexed dominant middle finger

strike twice

18
Q

normal sounds for percussion

A

tympanic or hollow sound over stomach and bowels or more air filled organs unless full of “substance”

deep resonance or lasting sound over thorax/lungs

dullness over more solid or full organs (i.e. heart, diaphragm, or spleen)

19
Q

where to percuss the stomach

A

closer to the L rib cage just inferior to the sternum

tympanic or hollow sound if empty; otherwise dull if full

20
Q

where to percuss the liver and findings

A

just above umbilicis along mid clavicular line

progress superiorly

starts with tympany or hollow sound

changes to dullness at liver (2.5-5 in)

resonance of lung tissue begins superior to liver

abnormal = large area of dullness

21
Q

where to percuss the spleen

A

starts at L lower rib cage anterior to axillary line

tympany or hollowness should be produced

move posteriorly toward mid axillary line; should become dull

dullness should be present between 9th and 11th ribs

abnormal = dullness found more medially and inferiorly or mull dullness while inspiring

22
Q

what is murphy test

A

percussion in sitting or prine with firm fist thumping on contralateral flat hand over costovertebral angle looking for pain

23
Q

how to perform palpations

A

start at firm light pressure in slow circular fashion with each quadrant

broad hand contact and possibly palpate through pt’s hand

forearm in same plane as abdomen

if no resistance or symptom provocation apply deeper pressire

also look for masses/guarding

normal = pressure

24
Q

abnormal palpation findings

A

tender/muscle guarding = swelling/dysfunction

confirm similar response with cough/percussion

progress to rebound tenderness if necessary by applying pressure then quick release

crepitus/crunchiness = excess air

hernias common around inguinal/umbilical regions

mass or cyst may be palpated

25
Q

where could you palpate gastritis or stomach inflammation

A

over epigastric area just inferior to sternum

26
Q

where could you palpate diverticulitis or intestinal inflammation

A

LLQ

27
Q

where could you palpate appendicitis

A

RLQ between ASIS and umbilicis

28
Q

where could you palpate hepatitis or liver inflammation

A

RUQ

ask pt to exhale and slowly move deeper during inhalation

inferior border is palpable

29
Q

where could you palpate pancreatitis q

A

mid clavicular line in RUQ with max exhalation

press and hold deeper pressure while pt is inhaling

30
Q

where to palpate spleen

A

Left lower rib cage at anterior axillary line

ask pt to exhale slowly and move deeper during inhalation under the rib cage

not palpable unless pathological

31
Q

where to palpate abdominal aortic artery

A

hook lying
use 2 index fingers
find pulse just L of umbilicus or L peri sternal line and assess up and down abdominal region

32
Q

what are you assessing with the abdominal aortic artery

A

strength

width by moving 2 fingers apart

normal width = 1 inch or 2.54 cm

abnormal = greater than 3 cm may indicate aneurysm then confirm with auscultation; may produce back pain

33
Q

what neuro tests could be performed with abdominal assessments

A

T7-12 dematomes with light and sharp touch from xiphoid process to inguinal ligament

superficial abdominal reflex for UMN lesion

34
Q

how to perform superficial abdominal reflex

A

diagonally stroke form umbilicus to outer border of each quadrant

umbilicus should move in the direction of the stroke

ClinMed II (12 decks)

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