Abdomen

Question 1

8 inspection

Answer 1

1. straie
2. lesion/ rashes/ scars
3. skin condition
4. umbilicus
5. vascularity
6. contour & symmetry
7. aortic pulsation
8. abdominal movement

Question 2

umbilicus inspection normal result

Answer 2

skin tone similar to surrounding skin, or even pinkish

Question 3

umbilicus inspection abnormal result

Answer 3

inverted: umbilicu hernia
sign of infection/ discharge (esp. in newborns)

Question 4

vascularity inspection normal inspection

Answer 4

scattered fine vessels ay be visible

Question 5

vascularity inspection abnormal inspection

Answer 5

dilated vessels: liver cirrhosis, vascular disease, ascites

Question 6

skin tone inspection normal result

Answer 6

paler than other part: less exposure to natural elements

Question 7

skin tone inspection abnormal result

Answer 7

yellow: jaudance
red/ bruise: inflammation/ injuries
purple: bleeding abdominal wall
taut skin: ascites

Question 8

Straie inspection normal result

Answer 8

new: pink bluish
old: streatch mark/ slilver

Question 9

Straie inspection abnormal result

Answer 9

dark blue: cushing syndrome

Question 10

lesion/ scar/ rash inspection normal result

Answer 10

none; old scar: pale & smooth

Question 11

lesion/ scar/ rashes: inspection abnormal result

Answer 11

nonhealing wounds: deep red, irregular
changes in moles

Question 12

contour & symmetry inspection normal result

Answer 12

flat, rounded, scaphoid (normal for thin adult)
symmetrical

Question 13

contour & symmetry abnormal inspection result

Answer 13

scaphoid: malnutrition
distended: 6F (fat, flatulance, feaces, fluid, fribroid, fetus)
asymmetrical: organ enlargment/ lack of fatty tissue

Question 14

Adominal movement inspection normal result

Answer 14

abdominal respiraotry movement

Question 15

Adominal movement inspection abnormal result

Answer 15

visible peristatic wave: bowel obstruction

Question 16

Aortic pulsation inspection normal result

Answer 16

slightly visible
may extend to full length in thin adults

Question 17

Aortic pulsation inspection abnormal result

Answer 17

exaggerated, vigorous, broad pulsation visible: abdominal aneurysm (shall check BP of both arms immediately)

Question 18

2 auscultation

Answer 18

1. bowel sound
2. vascular sound

Question 19

Bowel sound auscultation normal result

Answer 19

5-30 intermittent positive sound

Question 20

Bowel sond auscultation abnormal result

Answer 20

hyperactive: rushing may indicate diarrhea
hypoative: quiet & infrequent may indicate intestinal obstruction

Question 21

Vescular sound auscultation normal result

Answer 21

no bruit/ swishing sound is heard via bell side of stethoscope

Question 22

Vescular sound auscultation abnormal result

Answer 22

bruit (swishing) sound is heard: vascular issue (aeurysm/ renal vascular stenosis), need angiogram/ ultrasound

Question 23

Percussion normal result

Answer 23

dullness over liver area
tympany all over abdomen due o air in the instestine

Question 24

Percussion abnormal result

Answer 24

dullness in area other than the liver area: significant fluid/ matter exist in the intestine (fribre)
accentuated tmypany: distended abdomen

Question 25

2 types of palpation in abdominal assessment

Answer 25

light (1-2cm) & deep max. 5cm) perform light then deep palpation

Question 26

Palpation normal result

Answer 26

umbilicus & surrounding area free of swelling, bulging, masses should feel soft, non-tender without guarding mild tender over cecum, sigmoid colo, aorta when deep palpation

Question 27

palpation abnormal result

Answer 27

guarding: abnormal sign of abdominal wall spasm to protect abnormal organ Gurading (obj. sign) + parietal pain (subj. sign): internal organ rupture > need CT scan (computerized tomology)

Question 28

should palpation be performed to patient with abdominal aortic aneurysm

Answer 28

deep palpation should not be performed

Question 29

Inflammation of gallbladder: what is muphy sign

Answer 29

pain when pressure is applied to right costal margin area

Question 30

Liver palpation technique

Answer 30

hooking technique performed bimanually

Question 31

Liver palpation normal result

Answer 31

edge of the liver may be palpable in right costal margin, no enlargmenet

Question 32

Spleen palpation normal result

Answer 32

not palpable, no enlargement

Question 33

What position should be used for spleen palpation

Answer 33

right lateral/ side lyinh position

Question 34

kidneys palpation (left & right) normal result

Answer 34

not palpable, no enlargement

Question 35

bladder palpation normal result

Answer 35

empty bladder: not palpable distended bladder: smooth & rounded

Question 36

what is Rovsing sign? what does it ssuggest? what should normal result be like?

Answer 36

when pressure is aplied to LLQ, RLQ feels rebound pain when pressure is quickly relieved suggest aute appendicitis normal: no rebound pain is triggered

Question 37

what is psoas sign? (when hyperextend client's right leg, RLQ feels pain)

Answer 37

suugest iliopsoas irritation due to appendicitis

Question 38

Obturator sign

Answer 38

irritation of obturator muscle due to appendicitis

Question 39

TGRR stands for?

Answer 39

Tenderness, guarding, rebound pain, rigidity