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H&P Abdomen > Abdomen > Flashcards

Abdomen Flashcards

1
Q

RUQ Pain

A
  • Appendicitis (referred pain)
  • Cholecystitis & biliary colic
  • Congestive Hepatomegaly
  • Hepatitis or Hepatic abscess
  • Perforated Duodenal ulcer
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2
Q

RLQ Pain

A
  • Appendicitis
  • Cecal diverticulitis
  • Meckal diverticulitis
  • Mesenteric adenititis
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3
Q

LUQ Pain

A
  • Gastritis

- Splenic disorders (abscess, ruptures)

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4
Q

LLQ Pain

A
  • Ischemic colitis

- Sigmoid diverticulitis

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5
Q

RLQ or LLQ pain

A
  • Abdominal or psoas abscess
  • Abdominal wall hematoma
  • Cystitis
  • Endometriosis
  • Incarcerated or strangulated hernia
  • IBS
  • PID
  • Renal Stone
  • Ruptured abdominal aoritic aneurysm
  • Ruptured ectopic pregnancy
  • Torsion of ovarian cyst or testes
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6
Q

Diffuse Abdominal Pain

A
  • Acute pancreatitis
  • DKA
  • Early appendicitis
  • Gastroenteritis
  • Intestinal obstruction
  • Mesenteric ischemia
  • Peritonitis (any cause)
  • Sickle cell crisis
  • Typhoid fever
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7
Q

Abdominal 9 quadrant method

A
  1. Right hypochondriac region
  2. Right lumbar region
  3. Right iliac region
  4. Epigastric region
  5. Umbilical region
  6. Hypogastric region
  7. Left hypochondriac region
  8. Left lumbar region
  9. Left iliac region
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8
Q

Right hypochondriac region organs

A
  • Liver
  • Gallbladder
  • Right Kidney
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9
Q

Right Lumbar Region Organs

A
  • Liver (tip)
  • Small intestines
  • Ascending colon
  • Right kidney
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10
Q

Right Iliac Region Organs

A
  • Small intestines
  • Appendix
  • Cecum and ascending colon
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11
Q

Epigastric Region Organs

A
  • Stomach
  • Liver
  • Pancreas
  • Right and Left kidneys
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12
Q

Umbilical Region Organs

A
  • Stomach
  • Pancreas
  • Small intestines
  • Transverse colon
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13
Q

Hypogastric Region Organs

A
  • Small intestines
  • Sigmoid colon
  • Bladder
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14
Q

Left Hypochondriac Region Organs

A
  • Stomach
  • Liver (tip)
  • Left kidney
  • Spleen
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15
Q

Left lumbar Region Organs

A
  • Small intestines
  • Descending colon
  • Left kidney
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16
Q

Left Iliac Region Organs

A
  • Small intestines
  • Descending colon
  • Sigmoid colon
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17
Q

Retroperitoneal Organs

A 
SAD PUCKER:
Suprarenal (adrenal) gland
Aorta and IVC
Duodenum (2nd-4th)
Pancreas (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus (lower 2/3)
Rectum (partially)
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18
Q

Intraperitoneal Organs

A
  • Liver
  • Gallbladder
  • Spleen
  • Stomach
  • Jejunum
  • Ileum
  • Cecum
  • Transverse and sigmoid colon
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19
Q

Heartburn Symptoms

A
  • Burning feeling in chest
  • CP after eating or when lying down, occurring at night in bed
  • A burning sensation in the throat accompanied by a bitter or sour taste
  • Intermittent difficulty or pain on swallowing
  • Ongoing cough
20
Q

Indigestion Symptoms

A
  • Feeling of being uncomfortably full
  • Passing wind-burping and flatulence
  • Bouts of reflux
  • Bloating
  • Nausea
  • Intermittent vomiting
  • Heartburn
21
Q

GERD six’s

A

Dominant:

  • Heartburn (retrosternal burning sensation, which may rise to the back of the throat)
  • Acid regurgitation

Other:

  • Epigastric pain or burning
  • Nausea
  • CP
  • Dysphagia
  • Bloating
  • Belching
  • Cough
  • Sore throat
  • Hoarseness
  • SOB
  • Wheezing
22
Q

Dysphagia: Neurologic disorders

A

-Stroke
-Parkinsons dz
-MS
Giant cell arteritis

23
Q

Dysphagia: Muscular disorders

A
  • Myasthenia gravis
  • Dermatomyositis
  • Muscular dystrophy
  • Cricopharyngeal incoordination
24
Q

Dysphagia: Motility disorder

A
  • Achalsia
  • Diffuse esophageal spasm
  • Systemic sclerosis
  • Eoisinophilic esophagitis
25
Q

Dysphagia: Mechanical Obstruction

A
  • Peptic stricture
  • Esophageal CA
  • Lower esophageal rings
  • Esophageal webs
  • Radiation stricture
  • Extrinsic compression (aortic aneurysm, enlarged left atrium thoracic tumor)
26
Q

Odynophagia: Sharp and burning

A

Suggest mucosal inflammation

-Reflux esophagitis or infection

27
Q

Odynophagia: Sharp and sticking

A

Suggest mechanical

-Fish or chicken bone

28
Q

Odynophagia: Squeezing/cramping

A

Suggest muscular etiology

-Esophageal spasm, achalasia (dysfunction of normal wave like peristaltic contractions)

29
Q

Gastroparesis

A

ANS dysfunction to our stomach: Get full very quickly, slow emptying of stomach, bloating, elevated blood sugars (Usually our diabetics)

30
Q

Constipation

A

Feeling like you have to go and you can’t and there has been a change in your bowel movements, and when you do have bowel movement they are strained and usually pebble like

31
Q

Upper GI bleeding

A
  • Duodenal ulcer
  • Varices
  • Gastric ulcer
  • Mallory-Weiss tear
  • Erosive esophagitis
  • Angioma
  • GI stromal tumors
32
Q

Lower GI bleeding

A
  • Anal Fissures
  • Angiodysplasia
  • Colitis: radiation, ischemia, infectious
  • Colonic carcinoma
  • Colonic polyps
  • Diverticulitis dz
  • IBS, Crohns dz
  • Internal hemorrhoids
33
Q

GI Exam: Inspection- Contour

A
  • Flat
  • Scaphoid
  • Distended
  • Protuberant
  • Symmetrical
34
Q

GI Exam: Inspection- F’s of abdominal distention

A
  1. Fat
  2. Fluid
  3. Feces
  4. Fetus
  5. Flatus
  6. Full bladder
  7. Fatal tumor
  8. Fibroid
35
Q

GI Exam: Inspection-Movement

A

Peristalsis
Respirations
Aortic pulsations

36
Q

GI Exam: Inspection-Skin

A 
Scars
Striae
Discoloration (jaundice)
Venous patterns
Edema
37
Q

Cullen’s sign

A

Intraperitoneal hemorrhage

38
Q

Grey Turner’s sign

A

Retroperitoneal hemorrhage

39
Q

Ascites

A

Fluid in the abdomen

-Liver dz, CHF, malnutrition

40
Q

Percussion of Liver

A
  1. Start at an area of tympany at the Right MCL and percuss down to dullness; mark that spot
  2. Then begin from an area of tympany at the right MCL and percuss up to dullness; mark this spot
    * Normal = 6-12 cm or 2.5-4.5 inches
41
Q

Obturator Sign

A

-Have patient lay on back, passively flex right hip and knee, and passive internal rotation: reproduce RLQ with this is a positive obturator sign

42
Q

Psoas Test

A
  1. Place your hand just above the patient’s right knee
    and ask the patient to raise that thigh against your hand (against resistance)
    -Positive sign= Painful (posas muscle contracts)
  2. Ask the patient to turn onto the left side. Then extend the patient’s right leg
    at the hip
    -Positive sign=Painful (stretching the Psoas)
43
Q

Murphy’s Sign

A

Press on RUQ, have patient take a deep breath as you push in and up, if stop mid-breath= Positive Murphy’s sign, acute cholecystitis

44
Q

McBurney’s sign

A

Rebound tenderness with palpation at McBurney’s sign

-Appendicitis

45
Q

CVA Tenderness

A

a. k.a. Murphy’s punch sign

- Assess for pyelonephritis

46
Q

Rovsing Sign

A

Press deeply and evenly in the left lower quadrant. Then quickly withdraw your
fingers. Look for referred rebound tenderness

47
Q

Auscultation of the abdomen

A
  • Listen for 15-20 seconds in each quadrant
  • Listen for 5 minutes before determining “absent bowel sounds”
  • Bowel sounds described as” Normative, hypoactive, hyperactive, absent

H&P Abdomen (2 decks)

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