Abdomen

Question 1

Situs Inversus Totalis

Answer 1

All organs on the opposite side of the body

Question 2

Dextrocardia

Answer 2

Situs Inversus Totalis (organs flipped to other side) but involving only the heart

Question 3

The 9 regions of the abdomen

Answer 3

1. Epigastric
2. Umbilical
3. Hypogastric (suprapubic)
4. R hypochondriac
5. L hypochondriac
6. R lumbar
7. L lumbar
8. R inguinal
9. L inguinal

Question 4

What organs to consider in the RUQ

Answer 4

Liver

gallbladder

duodenum

(pancreatic head)

Question 5

What organs to consider in the RLQ

Answer 5

Cecum

appendix

right ovary and tube

Question 6

What organs to consider in the LUQ

Answer 6

Stomach

spleen

pancreas

Question 7

What organs to consider in the LLQ

Answer 7

Sigmoid colon

left ovary and tube

Question 8

What organs to consider in the epigastrium?

Answer 8

Stomach

pancreas

Question 9

Order of abdominal exam

Answer 9

1. Inspect
2. Auscultate
3. Percuss
4. Palpate

Question 10

Special tests- test for ascites

Answer 10

Shifting dullness

fluid wave

Question 11

Special test for peritoneal signs associated with appendicitis

Answer 11

Rosving’s sign

Psoas sign

Obturator sign

Question 12

Murphy’s sign

Answer 12

Special test for gallbladder inflammation

Question 13

What side do you stand on during an abdominal exam

Answer 13

The patients right side

Question 14

What does percussion assess?

Answer 14

Size and density of organs

areas of tenderness

presence of solid/fluid vs air

distribution of air (ex bowel obstruction)

organomegaly

masses

Question 15

How to percuss for liver size

Answer 15

upper border: start at 4th ICS percuss down

Lower border: start at umbilicus at MCL and percuss up

Question 16

What palpable size of the aorta suggests a AAA?

Answer 16

>3cm

Question 17

Encarcerated hernia

Answer 17

no pain, not reducible

Question 18

strangulated hernia

Answer 18

+pain, not reducible

emergency**

Question 19

What does an acute abdomen usually result from?

Answer 19

bowel obstruction or peritonitis

Question 20

Mechanical bowel obstruction vs ileus

Answer 20

mechanical- results from

a physical barrier

Ileus- due to bowel not functioning properly but no barrier in the way

Question 21

Renal calculi

Answer 21

kidney stones

Question 22

Common cause of pain in the LLQ

Answer 22

Diverticulitis (inflamed/infected diverticulum of the colon)

Question 23

diverticulum

Answer 23

Abnormal sac or pouch formed at a weak point in the wall of the alimentary tract

Question 24

visceral pain

Answer 24

when organs (ex: intestine, biliary tree) contract forcefully or distend or stretch abnormally

Quality: gnawingk, burning, cramping, aching

Question 25

Parietal abdominal pain

Answer 25

peritonitis inflammation of the parietal peritoneum movement increases pain

Question 26

Referred pain to the back

Answer 26

could be caused by pancreas, ulcer or GB

Question 27

Possible causes of referred right shoulder or scapula pain

Answer 27

GB, biliary tree

Question 28

what causes severe constant pain

Answer 28

pancreatitis

Question 29

what causes pain that is steady and gradual in onset

Answer 29

Appendicitis, cholecystitis

Question 30

What causes intermittent (colicky) pain?

Answer 30

Mechanical small bowel obstruction

Question 31

What causes severe colicky pain

Answer 31

ureteral stone

Question 32

Purple striae

Answer 32

indicates cushings dz and steroid use normal colored/white striae= stretch marks

Question 33

Cullen's sign

Answer 33

Discoloration over the umbilicus

Question 34

Grey Turner's sign

Answer 34

Ecchymosis over the flanks

Question 35

Diastasis recti

Answer 35

separation of rectus abdominus check by asking pt to lift up neck

Question 36

increased peristaltic activity

Answer 36

may be seen with bowel obstruction or gastroenteritis can be normal

Question 37

borborygmi

Answer 37

loud, active bowel sounds

Question 38

What do hyperactive bowel sounds indicate?

Answer 38

early peritonitis early bowel obstruction gastroenteritis

Question 39

high pitched, tinkling bowel sounds

Answer 39

early bowel obstruction intestinal fluid under pressure

Question 40

ileus

Answer 40

little to no bowel sounds Peritonitis starts as hyperactive and then can progress to ileus

Question 41

what are the possible causes of hepatomegaly?

Answer 41

cirrhosis hepatitis abscess cyst CHF tumor