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Clinical Med > Test 4 > Flashcards

Test 4 Flashcards

1
Q

Abd exam basic structure:

A

look
listen
feel - percuss then palpate

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2
Q

Three patterns of pain

A

1) visceral-solid organ when capsule stretches;hollow organs;difficult to localize;varies in quality (gnawing, burning, cramping..);associated sympt(sweating, pallor, nausea…);
2) pariertal-inflam in parietal peritoneum; steady or achy; more severe than visceral; worse with movement
3) referred-develops as initial pain worsens; superficial or deep; usually localized; may be from a completely dif area

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3
Q

R UPPER QUAD

A 
liver and gallbladder
pylorus
duodenum
head of pancreas
right adrenal gland
part of R kidney
hepatic flexure of colon
portions of ascending and transverse colon
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4
Q

L UPPER QUAD

A 
left lobe liver
spleen
stomach
body pancrea
left adrenal
part of L kidney
splenic flexure
part of transverse and descending colon
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5
Q

R LOWER QUAD

A 
lower pole of right kidney
cecum and appendix
bladder (if distended)
ovary and salpinx
uterus (if enlarged)
R spermatic cord
right ureter
portion of acending colon
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6
Q

L LOWER QUAD

A 
lower pole left kidney
sigmoid colon
bladder (if distended)
ovary and salpinx
uterus (if enlarged)
left spermatic cord
L ureter
portion  of descending colon
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7
Q

Grey-Turners sign

A

bruising of the flanks (ecchymosis)
causes: pancreatitis, abd trauma, ruptured AAA, ruptured ectopic prego, hemoperitoneum)

LOW SPECIFICITY AND DISAPPOINTING SENSITIVITY

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8
Q

Cullens sign

A

Periumbilical ecchymosis
causes: Panceatitis, ruptured ectopic prego

LOW SPECIFICITY AND DISAPPOINTING SENSITIVITY

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9
Q

test name for peritonitis:

A

heel jar or markle

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10
Q

linea negra

A

line of pigmentation that often dev during pregnancy

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11
Q

caput medusa

A

dialated tortuous supervicial veins radiating upward from the umbilicus

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12
Q

diastasis recti

A

separation between the left and right side of the rectus abdominus muscle

prominent when patient raises head

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13
Q

scaphoid

A

sunken in abdomen - malnutrition

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14
Q

distended lower half

A

buldge kind of umbilicus down-ish - bladder distention, pregnancy, ovarian mass, sigmoid tumor

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15
Q

protuberant abdomen

A

whole abdomen pretty big - excess gass, ascites, organ enlargement, obesity

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16
Q

long prolonged gurgles abdomen

A

borborygmi:normal sounds
rate of 5-35 per min
stomach growl gr

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17
Q

increased sounds abdomen

A

gastroenteritis

early obstruction or hunger

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18
Q

high pitched tinkling abdomen

A

intestinal fluid and air under pressure

early obstruction

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19
Q

decreased sounds abdomen

A

peritonitis and paralytic ileus

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20
Q

absent sounds abdomen

A

must listen for a full five minutes
associated with pain and rigidity
==surgical emergency

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21
Q

normal percussion sound usually is

A

tympanic (gas filled) or dull (fluid filledbowel)

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22
Q

what suggests intestinal obstruction?

A

protuberant abdomen that is diffusely tympanitic

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23
Q

tympany

A

muscial note of higher pitch than resonance

located over air filled viscera

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24
Q

hyperresonance

A

between tympany and resonance

located at base of lung

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25
Q

resonance

A

sustained note of moderate pitch

located over lung tissue and sometimes abdomen

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26
Q

dullness

A

shot, high pitched note with little ressonance

located over solid organs adjacent to air-filled structures

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27
Q

what is the test for ascites:

A

fluid wave test… assistant hand on mid line and you puhs/nudge one side toward midline swiftly… if “wave” is felt to other side of assistnat’s hand then there is ascites

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28
Q

shiftin dullness test

A

another test for ascites – laying down and standing up … dullness and tympanic sound line will move if ascites

29
Q

lloyd’s punch test

A

costovertebral angle tenderness (kidneys)

first palpate and askif pain.. indirect thump then … ifkidney infection or whatever itll be painful

30
Q

tenderness is…

A

discomfort elicited by palpation

31
Q

guarding is

A

VOLUNTARY contraction of the abd musculature due to tenderness, fear, the examiners cold hands or patient’s anxiety

32
Q

rebound is…

A

abd tenderness that is WORSE when palpating fingers are quickly removed from the place of palpable tenderness

33
Q

peritonitis is…

A

inflamation of the peritoneum made worse by patient movement, abd wall percussion, and with palpation

34
Q

burning pain in adbomen

A

peptic ulcer

35
Q

cramping pain in abd

A

biliary colic, gastroenteritis

36
Q

colicky pain in abd

A

appendicitis with impacted feces, renal stone

37
Q

aching pain in abd

A

appendiceal irritation

38
Q

knifelike pain in abd

A

pancreatitis

39
Q

ripping or tearing pain in abd

A

aortic dissction

40
Q

gradual pain in abd

A

infection

41
Q

sudden pain in abd

A

duodenal ulcer, acute pancreatitis, obstruction, or perforation

42
Q

common pancreatitis stuff

A

-sudden LUQ epigastric or umbilical pain
-may refer to L shoulder
-associated: vomitting, fever, shock
-PE: epigastric tenderness; + Grey turner;
+ Cullen
-most common causes: gallstones and excessive alcohol
-less commonly: hypertriglycidemia

43
Q

common cholecytitis stuff

A
  • severe, unrelenting RUQ or epigastric pain
  • refers to right subscapular area
  • associated: anorexia, vomiting, fever, jaundice
  • PE:RUQ tender; +Murphy
44
Q

common diverticulitis stuff

A
  • LLQ pain or localized to diseased area
  • associated: fever, anorexia, dhiarrea
  • PE:LLQ pain on palpation; borborygmus
  • common of large intestine - formation of pouches (diverticula) on the outside of colon and inflamation of the diverticula
45
Q

common pelvic inflamatory disease stuff

A
  • Lower quad in sexually active female
  • associated: nausea, vomiting, cervical dischange, dyspareunia
  • PE: adnexal and cervical tenderness
  • basically infection of uterus, fallopian tubes and ovaries - can form scar formation
46
Q

common appendicitis stuff:

A
  • intitially present with periumbilical or epigastric pain that localized to RLQ
  • colicky
  • associated: fever, nausea, vomiting, anorexia
  • PE: guarding; +obturator, iliopsoas, rovsing, markle, Mcburney signs
  • inflmation of appendix
47
Q

colon risk factors:

A
  • 50+ years
  • family history
  • personal history: polyps, crohns or ulcer diease, FAP, HNPCC, ovarian or endometrial cancer
  • ethnic: Jewish
  • low fiber and high fat
  • low fruit and veg intake
  • obesity
  • smoking
  • lack of reg exercise
  • alchol in high q
48
Q

blumberg

A

rebound tenderness (peritoneal irritation, appendicitis)

49
Q

cullen

A

ecchymosis around umbilicus (hemoperitoneum, pancreatitis or ectopic prego)

50
Q

dance

A

absence of bowel sounds

51
Q

kehr

A

abdominal pain radiating to left shoulder (spleen rupture, renal calculi, or ectopic prego)

52
Q

romberg-howship

A

pain medial aspect thight to knee (strangulated obturator hernia)

53
Q

rowsing

A

RLQ pain worsened by palpation of LLQ (peritoneal irrituation or appendicitis)

54
Q

ballotement

A

palpation technique use to find/examine floating objects in the body

55
Q

chelecytisis

A

inflammation of the gallbladder

56
Q

cholelithiasis

A

stone formation in the gallbaldder

57
Q

colic

A

spasm in any hollow tubular soft organ accompanied by pain

58
Q

dyschezia

A

painful or difficult cowel movement

59
Q

dyspepsia

A

imperfect digestion - not a disease itself but symptomatic of other diseases. vague abd discomfort, sense of fullness after eating, erucation, heartburn, nausea, vomiting, loss of appetite

60
Q

dysphagia

A

difficulty swallowing

61
Q

hematemesis

A

vomiting of blood

62
Q

hematochezia

A

blood in poop

63
Q

icterus

A

pigmentation of skin and eye (jaundice thing)

64
Q

striae

A

streaks or lines (with a slivery or purple hue) skin striae result from weakening of the lastic tissue associated with pregnancy, weight gain, rapid growth, and high levels of corticosteroids

65
Q

melena

A

evacuations resembling tar due to action of intestinal juices on free blood

66
Q

intussusceoption

A

prolapsing or telescoping of one segment of intestines into another, causing intestinal obstruction

67
Q

aaron

A

pain or distress occurs in the area of the patients heart or stomach on palpitation of mcburneys point (appendicitis)

68
Q

ballance

A

fixed dullness to percussion in left flank & dullness in right flank (peritoneal irritatuino)

69
Q

rovsing sgin

A

right lower quadrant pain is increased with palpation of LLQ

equiv to rebound tenderness

Clinical Med (7 decks)

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