Chapter 11: Abdomen

Question 1

Anatomy

Answer 1

Rectus abdominis
umbilicus
midline: overlying linea alba

Question 2

Identifying locations

Answer 2

RUQ, LUQ, RLQ, LLQ

Epigastric, umbilical, suprapubic

Question 3

RUQ structures

Answer 3

liver, gallbladder, lower pole rt kidney

Question 4

LUQ

Answer 4

spleen, pancreas

Question 5

LLQ

Answer 5

tubular colon

Question 6

RLQ

Answer 6

bowel, appendix

Question 7

RUQ or epigastric pain

Answer 7

Biliary tree, liver

Question 8

epigastric pain

Answer 8

stomach, duodenum, pancreas

Question 9

periumbilical pain

Answer 9

small intestine, appendix, proximal colon

Question 10

suprapubic, sacral pain

Answer 10

rectum

Question 11

hypogastric pain

Answer 11

colon, bladder, uterus

Question 12

ureteral pain

Answer 12

referred down inner thigh into testes

Question 13

sequence of exam

Answer 13

inspection, auscultation, percussion, palpation

Question 14

bruits

Answer 14

renal, aorta, iliac, femoral

Question 15

rebound tenderness

Answer 15

peritoneal inflammation

Question 16

pleurisy

Answer 16

abd pain and tenderness r/f pleural inflammation-when unilateral may mimic cholecystitis or appendicitis

Question 17

acute salpingitis

Answer 17

freq bilateral, tenderness (inflammation of fallopian tubes) usu max above the inguinal ligaments. +rebound tenderness and rigidity. pelvic-motion of uterus causes pain

Question 18

rosving’s sign

Answer 18

Press deeply and evenly in LLQ then withdraw. pain in rlq during left sided pressure suggests appendicitis

Question 19

psoas sign

Answer 19

Place your hand above the pt right knee. ask pt to raise that thigh against hand.
pain from irritation of the psoas muscle suggests inflamed appendix

Question 20

obturator sign

Answer 20

FLEX THE PT RIGHT THIGH AT HIP, with the knee bent, and rotate the leg internally at the hip-stretches the internal obturator muscle.

right hypogastric pain in a positive obturator sign-inflamed appendix

Question 21

murphy’s sign

Answer 21

hook thumb under the right costal margin at edge of the rectus muscle and ask patient to take a deep breath. sharp tenderness and a sudden stop in inspiratory effort +murphy’s sign