ABD Flashcards
(23 cards)
What ribs protect most of the spleen?
Can you palpate the tail of the pancreas?
9-10-11
Not in a healthy adult
Which organs can be palpitated in the LLQ?
RLQ?
sigmoid colon (esp if it has stool)
Portions of transfers colon and descending colon
-none in a healthy adult
Tender CVA can indicate what?
kidneys tenderness, retrocecal appendicitis, hepatic abscess, acute cholecystitis
If Pt tries very hard to stay still, this may be a sign of…
If Pt constantly tries to move a lot or can’t sit still….
- peritonitis
- obstruction of the colon, SI, and stones of kidney or gallbladder (these cause colicky pain)
What syndrome may show pink-purple striae on the abdominal skin?
cushion’s syndrome
What is dehiscence?
spontaneous wound opening
Skin dehis- not so bad
Fascial Dehis- not so good
After hernia repair, and surgery- increases infection chances
DefSeparation
of the two rectus abdominis muscles, through which abdominal contents form a midline
ridge when patient raises his head and shoulders.
-Who will you see this with?
Diastasis Recti (localized bulge)
Often seen with repeated pregnancies, obesity, and chronic lung disease.
No clinical significance
Pt presents with a
benign, fatty tumor in the subcutaneous tissues almost anywhere on the body.
It is soft, lobulated, and mobile.
Lipoma
What are normal bowel sounds?
How long do you listen if there are no sounds?
Normal sounds include clicks and gurgles at 5-35 per minute.
Borborygmi: prolonged gurgles of hyperperistalsis (stomach growling).
Listen for 2 minutes before declaring BS absent.
High-pitched tinkling sound in the abdomen suggest what?
Rushes of high-pitched sounds coinciding with an abdominal cramp indicate What?
intestinal fluid and air under tension in a dilated bowel).
intestinal obstruction.
- Bruits that have both systolic and diastolic components over renal arteries suggest what?
- Bruits that have both systolic and diastolic components over the iliac or femoral arteries suggest what?
renal artery stenosis.
partial arterial occlusion or arterial insufficiency.
Where else can you hear the renal artery for bruits?
at the CVA
How large is a normal liver at the MCL
6-12cm
A periumbilical or upper abdominal mass with expanding pulsation > 3 cm wide suggests______
What are the risk factors?
AAA
Age > 65.
History of smoking.
Male gender.
First degree relative with a h/o AAA repair.
What is a positive murphys sign and what does it check for?
A sharp increase in tenderness with a sudden stop in inspiratory effort is a positive Murphy’s sign.
Acute Cholecystitis
Wheres is McBurneys point?
Whats it look for?
A surgical landmark, one-third the distance from the to the umbilicus (2) on the right side.
Appendicitis
Appendicitis shifting pain
Pain of appendicitis classically begins near the umbilicus, then shifts to the RLQ, where
coughing can increase pain, due to peritonitis.
Press deeply and evenly in a site remote from the area of tenderness
Pain in the RLQ with left-sided pressure suggests ________
appendicitis (positive Rovsing’s sign)
What does Psoas sign look for?
Retrocecal appendicitis
May also suggest abnormality in the retroperitoneum
What does the obturator sign look for?
Pelvic appendicitis
Right pelvic pain with this maneuver is a positive obturator sign; suggests irritation of obturator muscle by inflammation low in the pelvis, such as inflamed pelvic appendix.
What does the heel tap look for?
Movement of the peritoneum may cause pain if there is inflammation (i.e. peritonitis, not specific for
appendicitis)
Raise leg with knee locked in full extension; cupping heel in your hand, strike heel solidly with side of other fist.
Ascites may be caused by:
increased hydrostatic pressure in cirrhosis, CHF, and pericarditis.
It may also be caused by decreased osmotic pressure from nephrotic syndrome or malnutrition
Ascites test
With patient supine, percuss outward in several directions from the central area of tympany.
Map border between tympany and dullness
Shifting dullness
After mapping the borders of tympany and dullness, have patient turn onto one side.
Percuss and mark the borders again
