Abdominal examination Flashcards

1
Q

GI symptoms

A
Weight loss
Anorexia
Dysphagia
N and V
Altered bowel habit
PR bleeding
Haematemesis
Abdo pain
Abdo distension
Fatigue/ SOB
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2
Q

5 steps of GI exam

A
Inspection
Palpation
Percussion
Auscultation
Special tests
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3
Q

Special tests in GI examination

A

Transillumination

Shifting dullness

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4
Q

Observations from the end of the bed

A

Pain
Tachypnoea
Jaundice/cyanosed
Body habitus

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5
Q

Hand signs

A
Koilonychia
Leukonychia
Nail clubbing
Palmar erythema
Dupuytrens contracture
Liver flap
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6
Q

What can cause palmer erythema and leukonychia

A

Liver disease

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7
Q

Eye signs

A

Jaundice
Anaemia
Xanthelasma
Kayser fleischer rings

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8
Q

Who pulls the eye lid down

A

Ask the patient to

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9
Q

Mouth signs

A

Angular cheilitis
Glossitis
Mouth ulcers

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10
Q

Chest signs

A

Spider naevi
Gynaecomastia
Supraclavicular lymph nodes

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11
Q

How do you test for spider naevi

A

Press on the centre and it will blanch from outside in

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12
Q

Things to look for when the patient is lying flat

A
Scars, massess, pulsations
Stomas
Drains
Catheters
Caput medusae
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13
Q

5 causes of abdominal distension

A
Fat
Fluid
Faeces
Flatus
Foetus
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14
Q

4 things of stomas

A

Site
Type of bowel
Content
Type of bag

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15
Q

Cullens sign and grey turners sign

A

Appendicitis

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16
Q

Periumbilical bruising

A

Cullens

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17
Q

Retrosternal flank bruising

A

Grey turners

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18
Q

What should you do before palpating

A

Ask where the patient is most sore, and start far away

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19
Q

How do you palpate

A

Hand flat over each area and flex at the MCP. Look at the patients face

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20
Q

Where do you palpate

A

9 areas, deep then soft, liver, spleen, kidneys, AA, bladder

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21
Q

Liver

A

Deep breaths, 1cm below costal margin

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22
Q

How do you measure enlarged liver

A

How many finger breaths below the costal margin

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23
Q

What is murphys sign

A

RUQ tender. Breath in and pain under costal margin. Cholecystitis.

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24
Q

Spleen

A

Start at RIF, if you feel then it is enlarged

25
Q

Kidneys

A

One on top, one underneath and push up with the lower hand. Enlarged if can feel or theyre thin

26
Q

Big spleen signs

A
Cant get above
Can cross midline
Splenic notch
Moves down on inspiration
Cannot ballot the spleen
27
Q

Big kidney signs

A

Can get above
Doesnt cross midline
Doesnt move on inspiration
Ballotable

28
Q

Bladder

A

Palpable when >300ml. Can

29
Q

Rosvigs sign

A

Palpation in the LIF results in pain in the RIF. Can indicate appendicits

30
Q

Where do you percuss

A

Liver, spleen bladder

31
Q

Liver percussion

A

6th rib downwards then umbilicus up. Until resonant goes to dull

32
Q

Spleen percussion

A

Left anterior axillary line, lowest intercostal space. If changes from resonant to dull on inspiration then splenomegaly

33
Q

Bladder percussion

A

From umbilicus to pubic symphis. Wait from resonant to dull

34
Q

Shifting dullness

A

Wait for resonance change then get them to move over. If dullness has moved then indicates fluid

35
Q

Auscultation

A

Bowel sounds and describe them. Abdominal and femoral bruits.

36
Q

To complete the examination

ISHRUG

A
Inguinal lymph nodes
Stools
Hernial orrifices
Rectal examination
Urinalysis
Genitalia
37
Q

Technique of DRE

A

Left lateral or nee elbow position. Gloved, well lubricated finger

38
Q

Assess on DRE

A

Perineal skin, anal tone, rectal contents, prostate, cervix

39
Q

4 questions for scrotal swellings

A

get above?
normal testes?
tender?
transilluminate?

40
Q

What is it if you cant get above

A

Tumour
Tense hydrocele
Orchitis
Hernia

41
Q

What if you can get above

A

True scrotal swelling

42
Q

If it is a true scrotal

A

Can you transilluminate

43
Q

Cant feel above but does transilluminate

A

Hydrocele

44
Q

Cant get above and cant transilluminate

A

Spermatocele
Epididymitis
Epididymal tumour
TB

45
Q

Cant get above and cant transilluminate

A

Spermatocele
Epididymitis
Epididymal tumour
TB

46
Q

Right upper name

A

Right hypochondrium

47
Q

Right middle name

A

Right lumbar

48
Q

Right lower name

A

Right iliac fossa

49
Q

Middle upper name

A

Epigastrium

50
Q

Middle middle name

A

Umbilical

51
Q

Middle lower name

A

Hypogastric, suprapubic

52
Q

Left upper name

A

Left hyperchondrium

53
Q

Left middle name

A

Left lumbar/flank

54
Q

Left lower name

A

Left iliac fossa

55
Q

What is an enlarged left supraclavicular lymph node

A

Virchows node, troisiers sign. Met from GI cancer

56
Q

What is cassels method

A
Breathe in
Hold breathe
Tap
Breathe out
Hold breathe 
Tap
57
Q

What are you auscultating on abdo exam

A

Renal
Aortic
Femoral

58
Q

Abdominal conclusion

A

Abdomen was soft and non tender with no palpable masses. Aorta pulsatile and not expansile. No bruits. No organomegaly on palpation and percussion