Thorax, Abdomen, and pelvis

Question 1

Landmarking the scapula

Answer 1

T2 -> superior angle
T3 -> spine of scapula
T7 -> inferior angle
1st rib -> bellow clavicle

Question 2

Landmarking the spleen and kidney

Answer 2

Spleen -> left 10th rib
Kidney -> 12th rib

Question 3

Muscles of the trunk

Answer 3

Rectus abdominis (trunk flexsion)

External and Internal Obliques (trunk flexion, rotation and side flexion)

Transverse abdominis (trunk and lumbar spine core stability)

Question 4

Whats located in the Right upper quadrant (RUQ)

Answer 4

right lobe of liver
gallbladder
duodenum
head of pancreas
right adrenal gland
right kidney
superior ascending colon
right half transverse colon

Question 5

Whats located in the Left upper quadrant (LUQ)

Answer 5

left lobe of liver
spleen
most of stomach
jejunum and proximal
body and tail of pancreas
left adrenal gland
left kidney
superior descending colon
left half transverse colon

Question 6

Whats located in the Right lower quadrant (RLQ)

Answer 6

Cecum
appendix
most of ileum
inferior right uterine tuba
right ovary
ascending colon
right ureter
right spermatic cord

Question 7

Whats located in the left Lower quadrant (LLQ)

Answer 7

Sigmoid colon
inferior descending colon
left ovary
left uterine tube
left ureter
left spermatic cord

Question 8

Movements of the ribs during respiration

Answer 8

Inspiration: ribs are pulled up and forward
ribs 1-6 increase in anteroposterior dimension
rib 7-10 increase in lateral dimension

Question 9

Assessment of the THorax and Abdomen

Answer 9

life threats
focus on s/s that indicate life threats
continually monitor vitals or indication of shock/internal bleeding

Question 10

referred pain zone

Question 11

RIb Contusion

Answer 11

MOI: direct/indirect blow

S/S: localized pain w/ compression. Deformity, bruising, crepitus, painful/difficulty breathing, coughing blood, leans to injured side

Question 12

Rib Fracture

Answer 12

MOI: stress fracture or direct blow (rib 5-9), violent muscular contraction

S/S: pain with deep inspiration or caughing, shallow breaths, lean to injured side, localized swelling, discolouration, crepitus
CHECK for: coughing blood, abnormal breath sounds, rate and depth of respiration

M: acute = immobilize chest, Ice/NSAIDs
Severe = referral

Question 13

Runner’s Stitch

Answer 13

E: varies; untrained, sig increase mileage, postprandial

S/S: sharp pain or spasm in lower right chest wall during exercise

M: stop activity stretch arms overhead, forced expiration through pursed lips

Question 14

Hyperventilation

Answer 14

E: rapid rate of ventilation due to anxiety, stress, or asthma. develop a decrease amount of CO2 relative to O2

S/S: difficult breathing, panic state with gasping and wheezing

M: decrease rate of carbon dioxide loss. Slow respiration rate, breath into bag, normal respiration should return w/in 1-2 minutes

Question 15

Sternal fracture

Answer 15

MOI: high impact to chest. may cause contusion to underlying cardiac muscle

S/S: immediate loss of breath, tenderness over sternum, pain w/ deep breathing.
Signs of shock or weak rapid pulse may indicate more severe injuries

M: EMS, X-rays and monitor heart

Question 16

Sudden Cardiac Death Syndrome

Answer 16

E: Hypertrophic (thick cm w/ no increase in chamber)
Marfan’s syndrome (abnormality in ct result in weakening of aorta and cardiac vessels

S/S: do not exhibit signs prior to death, may exhibit chest pain, heart palpitation, syncope, nausea, sweathing, SOB, malaise and/or fever

M/P: counseling and screening.

Question 17

Hernia

Answer 17

1. Inguinal (75%)
2. femoral
   Males > females
   E: protusion of abdominal viscera. common - indirect; direct; femoral

S/S: visible deformity, tenderness, swelling aching feeling in the groin

M: referral

Question 18

Appendicitis

Answer 18

S/S: acute pain in lower right quadrant, loss of appetite, nausea and vomiting, low grade fever. Rebound pain - McBurney’s Point

Can lead to circulation problems if obstructed.