Week 7 - Abdomen Exam Flashcards
How do we prep for exams?
- Nails are clean and trimmed
- Wash your hands
- Empty bladder
What do we inspect for on the surface?
- Skin lesions
- Rashes
- Dilated veins
- Symmetry of bony landmarks
What is Cullen’s Sign?
Black marks over the belly button
What is Grey-Turner’s Sign? Associated with?
Blood on lower lateral abdomen; acute pancreatitis; blood from any source!
What is Cullen’s classicaly associated wiht?
Ruptured ectopic pregnancy
What could stretch marks (stria) indicate?
Cushing’s syndrome
Type of Abdomen Contours
- Flat (athletic)
- Rounded (young children or fat in adult)
- Scaphoid (thin adults
Could you see peristalsis in thin indiviudals?
Possibly
Do we auscultate before palpation and percussion?
YES!!!!!!!! Could move things upon the other two
How are bowel sounds heard?
Clicks and gurgles that occur irregulary and range form 5-35 per minute
Do we auscultate in all 4 quadrants? How do we listen?
Yes; light pressure with draphragm
Where do we listen for bruits?
- Aorta
- Renal arteries
- Femoral arteries
How do we listen to vascular things?
Diaphragm with heavy pressure
“Tinkling sounds with rushing”
Small bowel obstruction
Bruits
Renal stenosis, aortic aneurysm
Why do we percuss?
To get a sense of overall tympany and dullness
What sound is predominnat in abdomen?
Typmany because air is present in stomach and intesines
Where do we hear dullnes?
Over organs, solid masses, or distended bladder
Classify Liver Enlargement
Liver border more than 2-3cm (1in) below costal margin
Normal vertical span of liver?
6-12cm
How do we check liver tenderness when liver is not palpable?
Indirect fist percussion
Is the healthy liver tender?
No
Where do we percuss the spleen?
Just posterior to midaxilalry line
Where could we hear spleen?
6-9th rib
Define Traube’s Space
Semilunar region.
- 6th rib
- Midaxillary line laterally
- L costal margin inferiorly
Is Traube’s space typical tympanitic?
Yes; overlies fundus of stomach
How are pateints for assessing kidneys?
Sitting
When is a good time to check Chapman’s?
When percussing the kindey’s
SHould you depress the abdomen more than 1 cm? What kind of motion?
No; circular mottions
What should you determine about resistnace?
Voluntary or involuntary
How do we make abdomen softer?
Lift their knees, pillow under knees
Often you are able to feel what borders?
- Rectus abdominis
- Aorta
- Portions of colon
How can you help liver palpation?
Have the pt breath in and push diaphrgm down; ordinarily it is not palpable
Is a healtyh gallbladder palpable or painful?
No
Is spleen usually palpable?
No
Is either kidney palpable? Which is more common to feel?
No; R kidney
What should we determine when palpating aorta?
Direction of pulsation
What does a prominent laterl pulsation suggest?
Aortic aneurysm
Normal width of aorta?
2 1/2 cm
What is ascites?
Advanced skill testing for fluid wave
What is Murphy’s Sign? When is it positive?
Gallbladder palpation; when inspiration is halted secondary to pain
What is Boas Sign? Level?
Area of hyperesthesia we would expect with acute inflammation of gallbladder; T6-T9
Boas is same phenomenon as what?
Viscerosomatic reflex
What do we assess when looking for appendicitis?
Rebound tenderness or if pain is happening on opposite sinde
How do we distinguish between appendix or obtuartor?
Lift up knee and rotate
What is Robing’s Sign?
Where if you palpate opposite side of stomach as gallbladder, gallbladder side hurts
