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Advanced Health Assessment > Week 2 Abdomen > Flashcards

Week 2 Abdomen Flashcards

1
Q

Common or concerning symptoms of GI disorders

A

Indigestion
Nausea
Vomiting
Hematemesis
Abdominal pain
Dysphasia
Odynophobia
Change in bowel functions
Constipation
Diarrhea
Jaundice

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2
Q

Ask the patient about bowel movements

A

Frequency of BMs
Consistency
Pain with BM
blood, black/tarry stool
Color
Jaundice

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3
Q

History taking of problems of the abdomen

A

Prior medical problems related to abdomen
Surgeries of abdomen
Any foreign travel and occupational hazards
Use of tobacco, alcohol, illegal drugs
Med history
Hereditary disorders
Regurgitation
Vomiting

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4
Q

History taking of problems of abdomen: urinary tract

A

Frequency
Urgency
Pain
Color and smell
Difficulty starting
Leakage
Back pain

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5
Q

Visceral (somatic or nociceptive) pain

A

Forceful contraction or distention of hollow organs (stomach, colon). Solid organs (liver, spleen) can also generate this type of pain when they swell against their capsules

Gnawing cramping colicky aching

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6
Q

Parietal pain (inflammatory)

A

Inflammation from the hollow or solid organs that affect the parietal peritoneum. Parietal pain is more severe and is usually easily localized (ex appendicitis)

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7
Q

Referred pain

A

Originates at different sites but shares innovation from the same spinal level

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8
Q

Abdominal exam rubric

A

Inspect
Auscultation
Percuss
Light palpate
Deep palpate
Palpate other organs

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9
Q

Tympany

A

High pitched musical sound that indicates a hollow space filled by air or gas in stomach/intestines

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10
Q

Dullness

A

Suggests fluid or underlying organs like spleen or liver

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11
Q

Signs of acute abdomen

A

Abdominal pain with coughing
Rigidity
Guarding
Rebound tenderness
Percussion tenderness

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12
Q

Costovertebral angle (CVA)

A

Ulnar side of first lightly tap to note tenderness

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13
Q

Obturator sign

A

+ pain with inward rotation of hip with knee bent

Flip on left side, bring leg into flexion

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14
Q

Psoas sign

A

+pain with hand on thigh, ask patient to raise in opposition; contracts psoas muscle and produces pain in RLQ

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15
Q

Rovsings sign

A

+rebound tenderness of RLQ on palpitation of LLQ

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16
Q

3 techniques to determine appendicitis

A

Obturator sign
Psoas sign
Rovsings sign

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17
Q

Inspection of Abdomen

A

contour
pulsations or peristalsis visible
scars, ecchymoses, rashes
umbilicus

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18
Q

Ausculatation of Abdomen

A

all 4 quadrants
note quality and frequency of sounds
normal- 5-34 /min

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19
Q

Borborygmi

A

stomach growling
hyperperistalsis
can hear without stethoscope

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20
Q

mcburney’s point

A

appendicitis

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21
Q

Murphy’s sign

A

cholecystitis
+ pain on palpation RUQ, just under ribs

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22
Q

Grey Turner’s sign

A

pancreatitis
discoloration of left flank
rare

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23
Q

Cullen’s sign

A

pancreatitis
discoloration surrounding umbilicus

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24
Q

Somatic/visceral/tension pain

A

caused by an increased forcefulness of peristaltic contraction–> acute stretching of an organ capsule

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25
Q

inflammatory pain

A

caused by inflammation of peritoneum
starts generalized, later localizes to location of organ
deep, intense pain worsening with movement or coughing

26
Q

examples of possible diagnoses for somatic/visceral/tension abdominal pain

A

bowel obstruction, gastroenteritis, food-related

27
Q

examples of possible diagnoses for inflammatory abdominal pain

A

appendicitis, cholecystitis, pancreatitis

28
Q

ischemic abdominall pain

A

caused by inceased O2 demand and decreased O2 supply in the gut
deep intense continuous pain worsening with actiivities that increase O2 demand such s eating

29
Q

examples of possible diagnoses for ischemic abdominal pain

A

ischemic bowel, mesenteric artery, ischemia/infarct

30
Q

warning signs of “surgical abdomen”

A

intractable pain
acute, progressive pain over time
pain causing syncope or disturbing sleep
old surgical scars on the abdomen
localized pain

31
Q

cholecystitis definition

A

inflammation of gallblader

31
Q

subjefctive findings of cholecystitis

A

acute pain in RUQ with radiation to R shoulder
N/V
subjective fever

31
Q

historical risk factors of cholecystitis

A

prior gallbladder disease, family history, recent fatty meal, acute illness, >40, females>males

32
Q

objective/physical exam findings for cholecystits

A

+murphy’s sign
low grade fever
jaundice

33
Q

diagnostics for cholecystitis

A

RUQ US
HIDA scan
liver enzymes, WBC, CRP

34
Q

historical findings for pancreatitis

A

alchohol abuse *
HLD
medication induced (Diabetetes)
vascular disease
hyperparathyroidism and hypercalcemia
renal transplant pt

35
Q

subjective findings for pancreatits

A

severe abdominal pain (RUQ or Epigastric) with radiation to the back
severe N/V
subjective fever

36
Q

physical exam for pancreattisis

A

abdominal tenderness/distention, hypoactive bowel sounds, signs of severe disease/shock, diaphoresis

37
Q

diagnostics for pancreatitsi

A

high amylase and lipase
leukocytosis
CT scan
abdominal Xrays

38
Q

historical findings for appendicitis

A

common ages 10-30
gynecologic disorders aned gastroenteritis commonly present as appendicitis
peritonisits development in approx 36 hours

39
Q

subjective findings for appendicitis

A

severe RLQ pain
nausea
loss of appetitie
feeling need to defecate
increased pain with movement or cough
subjective fever

40
Q

objective findings for appendicitis

A

RLQ rebound tenderness
rosvings sign, obturator sign, psoas sign
fever

41
Q

diverticulitis

A

inflammation of a diverticulum

42
Q

historical findings for diverticulitis

A

> 60
connective tissue disease
marfan syndrome
chronic constipation
history of diverticula

43
Q

subjective findings for diverticulitis

A

generalized LLQ pain
subjective fever
constipation or diarrhea
N/V
very GENERAL symptom

44
Q

diagnostics for diverticulitis

A

CT scan can confirm, but usually done by clinical diagnosis
+stool for occult blood
leukocytosis
abdominal film
colonoscopy once less inflammed 7-10 days

45
Q

historical risk factors for GERD

A

medication use
common triggers such as citrus, tomatoes, caffeine, alcohol, chocolate
smoking
obesity

46
Q

GERD

A

the lower esophageal sphincter decreased resting tone, it allows gastric contents to go back up into the esphageal area and that relaxation that causes GERD

47
Q

subjectie findings for GERD

A

heartburn
relieved by antacids
frequent belching
cough,wheeze,aspiration,hoarseness, sensation of globus

48
Q

diagnostics for GERD

A

clinical diagnosis
trial of PPI
endoscopy if not resolved

49
Q

historial risk factors for PUD

A

h pylori infection
NSAID use
systemic corticosteroid use
age >50-55

50
Q

differences between gastric ulcer and duodenal ulcer

A

gastric- pain worsens after eating
duodenal- improves with eating

51
Q

indications for EGD

A

Bleeding
odynophagia
weight loss (unplanned)
early satiety
dysphagia

52
Q

historical risk factors of ectopic pregnancy

A

endometrisis, multiple D&Cs, abortions, history of tubal infection, infertility, PID, previous tubual surgery, IUD

53
Q

subjective findings of ectopic pregnancy

A

amenorrhea followed by spotting
sudden onsent of sever elower abdominal pain
back pain

54
Q

physical exam for ectopic pregnancy

A

tenderness on pelvic exam with palpable mass and blod in he pculdesac
abdominal distention with peritoneal signs

55
Q

diagnostics for ectopic pregnancy

A

urine or serum hCg
pelvic US
immediate surgery if rupture

56
Q

urinary calculi historical factors

A

men>women
heavy sodium/protein diet
hot humid climate
fam history

57
Q

subjective findings of urinary calculi

A

pain in flank, RLQ, LLQ, suprapubic area
severe acute colicky pain
N/V
urgency or frequency
report of hematuria

58
Q

physical exam for urinary calculi

A

CVA tenderness
otherwise normal

59
Q
A

Advanced Health Assessment (8 decks)

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