WEEK 7- ABDOMEN Flashcards
ABDOMEN, ANUS, RECTUM, PROSTATE
Conduct an independent review of anatomy & physiology.
Solid viscera
Liver, pancreas, spleen, kidneys, adrenal glands, ovaries, and uterus
Hollow viscera
Stomach, gallbladder, small intestine, colon, and bladder
Landmark the anatomical location of major organs by quadrants.
LUQ-spleen, stomach
LLQ-small intestine, sigmoid colon, descending colon
RUQ- liver, gallbladder,
RLQ-ascending colon, cecum, appendix
Outline relevant subjective questions
Appetite
Dysphagia
Pyrosis
Food intolerances
Abdominal pain
Nausea/vomiting
hematemesis
Bowel habits
Melena
Constipation
Past abdominal history
Medications
NSAIDs, herbal sup.
Nutritional assessment
Identify guidelines for preparation of objective data collection.
instruct the patient to empty the bladder, saving a urine
specimen if needed.
* Keep the room warm to avoid chilling and tensing of
muscles.
* Position the patient supine, with the head on a pillow, the
knees bent or on a pillow, and the arms at the sides or
across the chest. (Note: Discourage the patient from placing
arms over the head, because this tenses abdominal
musculature.)
* To avoid abdominal tensing, warm the stethoscope endpiece
and your hands, and keep your fingernails very short.
* Inquire about any painful areas. Examine such an area last to
avoid any muscle guarding.
Explain the use of the scratch test.
Maps lower edge of liver border
Stethoscope
Begin at RLQ
When sound magnifies…
- assess for the presence of ascites, which is an abnormal accumulation of fluid within the abdominal cavity.
Identify the purpose for assessment for costovertebral angle tenderness.
Costovertebral angletenderness
12th rib over costovertebral angle
Indirect fist percussion
- kidney pathology
Outline developmental, infant, pregnancy, aging adult
Infant & child
Protuberant
Umbilical stump
Pregnancy
Nausea, vomiting, acid indigestion, constipation, hemorrhoids, striae
Aging Adult
Deposits of subcutaneous fat and loss of musculature tone
Decreased salivation, taste, and constipation
Identify health promotion strategies.
Safe sex
Drink in moderation
Acetaminophen and alcohol
Protect self from hepatitis
Eat healthy
Environment
Identify equipment needed for physical examination & safe infection prevention & control practices.
Strong overhead light
Secondary stand light
Stethoscope
Small centimetre ruler
Skin-marking pen
Alcohol wipe (to clean endpiece)
Drape
Outline abnormal findings: Distension,
abnormal enlargement or swelling of an organ, tissue, or body part beyond its normal size or shape.
- fluid accumulation
- foreign body
- flatulence
- fecal contents
- growing fetus
hernias
Hernias can cause symptoms such as a visible bulge or lump in the abdomen, discomfort or pain, especially when lifting heavy objects, bending over, or coughing, and sometimes complications such as bowel obstruction
hypoactive and hyperactive bowel sounds
Hypoactive bowel sounds refer to a decrease in the normal sounds heard during abdominal auscultation. This can indicate reduced or absent intestinal motility.
Hyperactive bowel sounds refer to increased or exaggerated bowel sounds heard during abdominal auscultation. These sounds may be louder, more frequent, or of higher pitch than normal.
vascular sounds
vascular sounds in the abdomen refer to the audible noises produced by blood flow through major blood vessels within the abdominal cavity.
- ABNORMAL: BRUITS
abdominal aortic aneurysm.
An abdominal aortic aneurysm (AAA) is a localized enlargement or ballooning of the abdominal aorta, the main blood vessel supplying blood to the lower body. - – Check for lump/mass in abdomen
how to prepare for abdomen exam?
Empty bladder
Warm Room
Positioning
Warm stethoscope
inspection- abdomen
Contour
Symmetry
Skin
Texture, scars, colour, lesions, dilated veins, rashes & striae
Umbilicus
“Cullen’s sign” inverted /protruding umbilicus
Pulsation or movement
Are pulsations or movements normal?
Hair distribution
Demeanor of the patient should be
symmetry
fat distribution
color changes
swelling
masses or lumps
auscultation- abdomen
Bowel sounds
Diaphragm or bell?
Where to begin auscultation?
RLQ at ileocecal valve
Note character
High pitched, gurgling, cascading sounds
Note frequency
hypoactive or hyperactive, intermittent, none
bowel sounds are listened to with
DIAPHARGAM SIDE- is more sensitive to high-pitched sounds, which are characteristic of normal bowel sounds
vascular sounds are listened to with
BELL SIDE- firmer pressure- listen for low frequency sound
percussion-abdomen
General tympany
percussion- Where and when might you hear dullness or hyperresonance?
dullness over solid- liver, spleen. hyperresonance when abdomen is distended. Tympany- gas filled, stomach, intestine
palpation- abdomen
Light palpation
Overall impression of skin surface and superficial musculature
Technique
Guarding, masses and tenderness
If you feel a mass…
Size, location, shape, consistency, surface, mobility, pulsatility & tenderness
what order should the assessment be done?
Inspection
auscultation
percussion
palpation
Bimanual assessment is used primarily for
- large abdomen
The rebound tenderness assessment is used for what type of concern?
- appendix assessment
The auscultation of the abdominal arteries may display bruits in:
iliac, renal, femoral arteries
The normal range of the liver span in an adult female is:
6-7cm
When assessing through palpation the abdomen the patient should:
supine w legs bent
Which of the following conditions is an example of visceral pain?
cholecystitis - internal
When palpating the abdomen of a patient you note the presence of tenderness in LUQ. Which structure is involved?
spleen
An abdomen that is bulging and stretched in appearance is described as:
protuberant
