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Abdomen Flashcards

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1
Q

What is the posterior landmark of the abdomen?

A

Costovertebral angle (CVA)
-formed by the lower border of the 12th ribs and upper lumbar vertebrae
-areas to asses for kidney tenderness

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2
Q

What are the major organs of the RUQ?

A

Liver
Gallbladder
Pylorus
Duodenum

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3
Q

What are the major structures of the LUQ?

A

Stomach
Spleen
Left lobe of liver

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4
Q

What are the major organs of the RLQ?

A

Cecum
Appendix
Right ovary
Right ureter

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5
Q

What are the major organs of the LLQ?

A

Sigmoid colon
Left ureter
Left spermatic cord

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6
Q

What can cause RUQ pain?

A

Cholecystitis
Renal Stone
Intestinal obstruction
Stomach inflammation

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7
Q

What can cause LUQ pain?

A

Pancreatitis
Renal stone
Intestinal obstruction
Stomach inflammation

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8
Q

What can cause RLQ pain

A

Appendicitis
PID
Ruptured ovarian cyst

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9
Q

What can cause LLQ pain?

A

Diverticulitis
bowel obstruction

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10
Q

What is heartburn?

A

a burning sensation in the epigastric area radiating into the throat; often associated with regurgitation

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11
Q

What is excessive gas or flatus?

A

needing to belch or pass gas by the rectum; patients often state they feel bloated

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12
Q

What is abdominal fullness?

A

Early satiety
- starting eating but feeling full after a couple bites

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13
Q

What is regurgitation/

A

the reflux of food and stomach acid back into the mouth; brine-like taste

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14
Q

What is blood or coffe ground emesis?

A

Hematemesis

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15
Q

What is visceral pain?

A

Hollow abdominal organs contracts forcefully or distended or stretched
- gnawing, burning, cramping, aching

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16
Q

What is parietal pain?

A

originates from inflammation from hollow or solid organs that affect the parietal peritoneum, called peritonitis
-more severe than visceral
-aggravated by movement

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17
Q

What is referred pain?

A

Originates at different sites but shares innervation form the same spinal level

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18
Q

What is a Kehr sign?

A

Abdominal pain radiating to left shoulder
-sign of splenic rupture or renal colic

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19
Q

What is hematochezia?

A

Blood in stool

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20
Q

What is Melena?

A

Black tarry stool

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21
Q

What can white or gray stools indicate?

A

Liver or gall bladder disease

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22
Q

What is the most common disorder of the esophagus?

A

GERD

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23
Q

How does GERD happen?

A

Incompetent LES allows stomach acid to go back up

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24
Q

What are common signs and symptoms of GERD?

A

S: Barrett’s esophagitis, strictures
Sx: heartburn (pyrosis), regurgitation, dysphagia

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25
What is Peptic Ulcer Disease?
Due to infection (helicobacter pylori)
26
What are the signs and symptoms of PUD?
S:Melena, hematochezia, anemia Sx: epigastric pain, cramping
27
Acute and chronic symptoms of diarrhea?
Acute: cramping, nausea, watery stools Chronic: skin breakdown, dehydration, weight loss
28
What causes jaundice?
Increased levels of bilirubin - bile pigment from hemoglobin breakdown
29
What is the mechanisms behind jaundice?
Increased production of bilirubin Decreased uptake of bilirubin Decreased ability of the liver to conjugate Decreased excretion of bilirubin into bile
30
What is the urine color and stool color of jaundice
Urine: dark yellowish, brown Stool: stools become gray or light colored
31
What are the 7 F’s of abdominal distension?
Fluid Feces Fetus Fat Flatus Fatal tumor Fibroid
32
What areas of the abdomen should be exposed?
Xiphoid process to suprapubic area
33
What is the order of the physical exaM?
Inspection Auscultation Percussion Palpation
34
What is the medical term for stretch marks/
Striae
35
Is peristalsis typical seen?
NO -may be seen in thin people -Seen with bowel obstruction
36
Are aortic pulsation visible?
Yes
37
What is a Cullen Sign?
Bluish periumbilical discoloration -Suggest intraabdominal bleeding
38
What is a grey turner sign?
Ecchymosis of the flanks -Suggest hemoperitoneum
39
What color will striae turn over time?
Turn silvery-white -initially pink or blue
40
If someone has Cushing disease what would the striae remain?
Purplish
41
When will you see a flat, rounded, scaphoid, distended, or protuberant abdomen
Flat: athletic Rounded: young children Scaphoid: thin, or malnourished Distended: abnormal state Protuberant: pregnancy, FAT MC
42
What are dilate veins called?
Caput Medusa
43
What is rectus diathesis?
Separation of rectus abdominis muscles with central linear bulging
44
What are bowel sounds a result of?
Peristalsis
45
What is normoactive bowel sounds
5-34 sounds per minute
46
What is Borborygmi
Stomach growling -prolonged gurgles of hyperperistalsis
47
What are hypoative bowel sounds?
May require up to 2 minutes to confirm diminished -found in ileus, paralysis of bowel, and peritonitis -complete absence indicates ischemic or infaracted bowel
48
What is a hyperactive bowel sounds?
Greater than 34 sounds per minute -high pitched, or tinkling sounds
49
What does a bruit sound like?
Whooshing
50
What side of the stethoscope do you use when assessing for bruits?
Bell over the arteries -listen in CVA for kidneys
51
Where to listen to the abdominal aorta/
Between the xiphoid process and umbilicus
52
What does liver and spleen friction rubs indicate?
Peritoneum - grating or rasping sounds (during inspiration)
53
What side of the stethoscope do you use for friction rubs liver and spleen?
Diaphragm
54
What is percussion used for?
To asses the size and density of organs and detect the presence of fluid, air, or solid masses
55
After the general inspection is done what organs to you have to go back to percuss?
Liver Spleen Gastric air bubble Bladder distension Kidneys
56
What is a normal size of a liver?
6-12cm
57
Where is the spleen located?
Left mid-axillary line -ribs 9,10, and 11 protect the spleen
58
How does the spleen enlarge?
Anteriorly, inferiorly, medially
59
Can a normal filled bladder be palpable?
No
60
What is the kidney percussion called?
Lloyd punch -should not cause pain or tenderness
61
What does +CVS tenderness suggest?
Pyelonephritis or musculoskeletal cause
62
If there is distention of inflammation of the kidneys what will the patient do when struck?
Jumped
63
When is Tympany heard?
Over air-filled structures -abdomen -stomach -bowel obstruction
64
When is dullness heard?
Over filled or solid organs -enlarged bladder -liver -spleen -constipated
65
If someone is in serve pain what order should you palpate?
Tender area last -ask patient to cough -will guard that area
66
How many hands is light and deep Palpation used with?
Light: one hand Deep: two hands (kneading)
67
How to determine a superficial or deep mass?
Superficial: stays with crunch Deep: disappears with crunch
68
When is the hook technique used for liver Palpation
In obese patients
69
Is it okay to palpate for a spleen?
No it needs to be investigated
70
If a spleen is enlarged how will it move?
anterior, downward, and medially displacement
71
What is an enlarged aorta?
3cm
72
What is occult blood?
Cannot see with naked eye
73
What is acute abdomen synonymous with?
Peritonitis (inflammation of the parietal peritoneum) -tell them to cough
74
What is rebound tenderness?
Deep Palpation vs sudden lifting -withdrawal pain=peritoneal irritation (+ rebound)
75
What is guarding?
Voluntary -tensing of the abdominal muscles -sign of acute peritonitis
76
What is rigidity?
Involuntary reflex contraction of abdominal muscles -board-like abdominal structures
77
What is classic appendicitis?
Inflammation of the appendix -localized periumbilical pain followed by RLQ
78
What is McBurney’s point?
2 inches from ASIS is McBurney’s Point -where appendix is
79
What is Rovsing sign/
Pain referred to RLQ when pressing deeply in the LLQ
80
What is Psoas sign?
peritoneal irritation over Psoas will cause pain in RLQ
81
What is the obturator sign?
Least sensitive test -flex right hip and knee at 90 degrees
82
What is Murphy sign?
Performed in patients with RUQ pain -suggest acute cholecystitis - inspiratory arrest (+)
83
What is ascities?
Accumulation of fluid in the abdominal cavity -protuberant abdomen - heart failure or cirrhosis
84
Fluid wave ascites or adipose?
Ascites: fluid moves under the hand Adipose: tap stops at the hand placed in midline
85
What is ballottement?
Used to identify an organ or mass -make a brief jabbing movement toward the structure
86
What is the most common cause of flank pain?
Hydronephrosis Pyelonephritis

Physical Assessment (12 decks)

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