week 6 abdominal assessment 2

Question 1

renal arteries

Answer 1

to the left and right of the umbilicus, slightly superior

Question 2

iliac arteries

Answer 2

half way between umbilicus and symphysis pubis

Question 3

percussion ascending colon

Answer 3

resonant

Question 4

percussion transverse colon

Answer 4

resonant

Question 5

percussion of edge of liver

Answer 5

dull

Question 6

percussion of gastric bubble

Answer 6

tympani LUQ

Question 7

percussion of small bowel

Answer 7

dull, more fluid than air

Question 8

percussion of large bowel

Answer 8

resonant

Question 9

liver percussion

Answer 9

midclavicular
liver span: 6-12cm
percuss up RMCL from umbilicus until dull sound of liver
then percuss down RMCL until dull sound

Question 10

liver <6cm

Answer 10

increased air in bowel

perforated bowel or stomach

Question 11

liver > 6cm

Answer 11

hepatomegaly

Question 12

percuss spleen

Answer 12

left MAL downward toward the lowest ICS
from resonance to dull
- may be between 6th and 10th ICS
- percuss before and after deep breath

Question 13

percuss kidney

Answer 13

mid back, sides of spine

put palm over kidney, percuss with fist of other hand

Question 14

light palpation

Answer 14

palmar surface with fingers extended

Question 15

medium palpation

Answer 15

explores abdominal organs
use side of hand-lateral aspect of 2nd digit
- feel edge of organs
– deep inspiration

Question 16

deep palpation

Answer 16

palmar surface with fingers extended

- left hand on skin with right hand on top to provide firm pressure

Question 17

palpation of liver

Answer 17

bring liver forward with L. hand under flank at CM pressing up

• R. hand finger tips placed under costal margin
• pt. take a deep breath fingers slid up under margin
• • liver edge smooth

Question 18

palpation of spleen

Answer 18

L. hand under flank and CM, pull up anteriorly
Fingers of R. hand slide along edge of rib
- pt. take deep breath

Question 19

palpation of kidney

Answer 19

L. kidney
- L. hand on flank, push anteriorly
R. hand extended, palmar surface of fingertips move down midclavicular line

Question 20

Psoas muscle test

Answer 20

lift straight leg up off table
- downward pressure to thigh/above knee 
-> tightening of psoas muscle
-- pain: abdominal inflammation 
OR
Pt on side bring upper leg in backward motion

Question 21

obturator muscle test

Answer 21

flex leg at hip and external rotate

• downward pressure on knee
• > tightening in peritoneum and pain with inflammation

Question 22

shifting dullness

Answer 22

with ascites

• percuss laterally
• • resonant -> dull = fluid line

Question 23

auscultate abdominal aorta

Answer 23

epigastric

Question 24

auscultate renal arteries

Answer 24

upper quadrants to side of umbilicus under costal margin

Question 25

auscultate iliac arteries

Answer 25

between the umbilicus and iliac crest

Question 26

older adult fecal incontinence patho

Answer 26

inability to control BM leading to leakage of stool 
3 major causes
- fecal impaction
- underlying disease
- neurogenic disorder

Question 27

fecal incontinence r/t fecal impaction

Answer 27

most common cause
immobilization and poor fluid and dietary intake
laxative overuse may also be a cause

Question 28

fecal incontinence r/t neurogenic disorder

Answer 28

any process that causes degeneration of the mesenteric plexus snd lower bowel
-> lax sphincter muscle, diminished sacral reflex, dec. puborectal muscle tone.

Question 29

fecal incontinence subjective

Answer 29

overflow incontinence: soft stool that oozes around the impaction
Unable to recognize rectal fullness and inability to inhibit intrinsic rectal contractions, have stools in a pattern, normally after meals

Question 30

fecal incontinence objective

Answer 30

dx with digital rectal examination when assessing rectal tone