Abdomen Flashcards
(21 cards)
What is tenderness and what causes it?
See/hear patient in pain on palpation
(if minimal pain elicits tenderness - peritonitis, anxiety)
What is rebound tenderness and what causes it?
Abdominal wall compressed slowly then released suddenly causes sharp stabbing pain
–> generalised/localised peritonitis
What is guarding and what causes it?
Abdominal wall contracts voluntarily when palpation causes pain
What is rigidity and what causes it?
Involuntary guarding
–> parietal peritonitis –> board-like rigidity
What pathology can make liver palpation possible?
Congestive heart failure
Hepatitis
Tumours
Liver cirrhosis
Cholecystitis
What pathology can make spleen palpation possible?
Haemolytic anaemia
What pathology can make kidneys bilaterally and unilaterally enlarged?
Bilaterally - polycystic kidney disease, amyloidosis
Unilaterally - renal tumour
What is the finding in AAA?
Pulsatile expansile mass
What is ascites and when does it happen?
Fluid in the peritoneal cavity due to
liver cirrhosis, liver cancers, heart failure
Why does liver failure cause ascites?
Decreased aldosterone/ADH metabolism by liver
Decreased albumin production so decreased oncotic pressure
These two factors causes fluid to leak into the peritoneal space
What causes reduced or absent bowel sounds?
Paralytic ileus
Peritonitis
What causes high pitch (tinkling) infrequent bowel sounds?
Small bowel obstruction
What are vascular bruits? Where would you auscultate for them? At each location what would bruits suggest?
Abnormal turbulent blood flow in arteries from aneurysm/obstruction
abdominal aorta (AAA)
superior mesenteric/coeliac arteries
renal arteries (stenosis)
liver tumours
iliac arteries (stenosis)
Where is gallbladder pain referred to?
What test can you do to confirm gallbladder inflammation?
right hypochondriac
palpate right subostal region on patients inspiration –> Murphy’s sign
What separates the spleen from the ribcage?
the diaphragm and costodiaphragmatic recess
Clinical presentation of hernias
Lumps in abdomen
Enlarges on coughing or straining
May be reducible/irreducible
If irreducible can become strangulated where blood supply is blocked and necrosis occurs
–> abdominal pain, nausea, vomiting
Outline the risk factors for hernias
Obesity
Male sex
Prematurity
Age
Smoking
FHx, PMHx,
Chronic coughing
Connective tissue disorders
Heavy lifting
Pregnancy
Outline the treatment for hernias
Surgery
Sometimes mesh is used
Where are the 3 most common spaces for ureteric stones?
pelvi-ureteric junction
as ureters cross over sacro-iliac joint
vesico-ureteric junction
narrows naturally at these sites
How do patients with AAA present?
Abdominal pain
Back pain
Abdominal pulsation awareness
Ripples in water when they bathe
Most asymptomatic
How would a patient with a ruptured AAA present?
Back/flank pain
Hypotension
Pulsatile expansile abdominal mass - tender with bruit
Cold/sweaty
Pulse weak/thready
