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Health Assessment final > Abdomen > Flashcards

Abdomen Flashcards

(61 cards)

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1
Q

What should be included in the ROS?

A

When’s the last time you went to the bathroom?
- What’s normal for you?
When was the last time you ate?
Nausea/vomiting/diarrhea/constipation/abnormality in stool?
Pain?
Food allergies? What’s your diet like?
Last menstrual cycle/any chance you could be pregnant?
Have you had any abdominal surgeries?
When was your last colonoscopy? (Geared towards >50)
Colace or other medications that can affect GI? Iron supplements?
On any daily narcotics that could cause constipation?
Proton pump inhibitors?
GERD? IBS/IBD?

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2
Q

How is the abdomen divided during examination?

A

4 quadrants:

RUQ, RLQ, LUQ, LLQ

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3
Q

What organs are located in the RUQ?

A 
Liver
Gallbladder
Head of pancreas
Right kidney
Right adrenal
Hepatic flexure of colon
Part of ascending and transverse colon
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4
Q

What organs are located in the RLQ?

A 
Cecum
Appendix
Right ovary and tube
Right ureter
Right spermatic cord
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5
Q

What organs are located in the LUQ?

A 
Stomach
Spleen
Left lobe of liver
Body of pancreas
Left kidney
Left adrenal
Splenic flexure of colon
Part of transverse and descending colon
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6
Q

What organs are located in the LLQ?

A 
Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord
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7
Q

Which is the largest and most palpable organ?

A

Liver

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8
Q

Where is the liver located?

A

The superior portion is about 5th ICS right side (RUQ)

Inferior portion sits around the right costal margin

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9
Q

Where is the stomach located?

A

Upper portion is around 5th or 6th ICS

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10
Q

Where is the pancreas located?

A

Behind the stomach

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11
Q

Where is the small intestine located?

A

R&LLQ

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12
Q

Where do the lower bowels dump into?

A

Cecum

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13
Q

What is usually in the cecum?

A

Liquid

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14
Q

Where is the appendix located?

A

RLQ

Sits by ascending colon

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15
Q

What does the transverse colon do?

A

Absorb water

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16
Q

Is the stool hard or soft in the descending/sigmoid colon and why?

A

Soft because water is absorbed

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17
Q

Where is the bladder located?

A

Suprapubic region

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18
Q

How many mL can the bladder hold before one feels the need to urinate

A

400-600 mL

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19
Q

How much fluid can the bladder hold?

A

~1L

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20
Q

Where is the uterus located?

A

Suprapubic region

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21
Q

What is peritonitis?

A

When the lining of the abdominal cavity is enflamed

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22
Q

What can cause peritonitis?

A

Ruptured appendix/ small/large intestines

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23
Q

What are general guidelines for abdomen assessment?

A 
Good lighting
Have pt empty bladder
Warm hands, stethoscope
Short fingernails
Warm room
Adequate covering
No shivering
Exposure from xiphoid process to the symphysis pubis
Ask if they have pain in the abd and point
- Examine tender areas last!!!
Watch pts face as you examine.
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24
Q

What is the sequence during the abd examination?

A

Inspection
Auscultation
Percussion
Palpation

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25
What can happen if you palpate before you listen?
Peristalsis disruption
26
How do you inspect the abdomen?
Have pt supine with one pillow under head, arms at sides, breath through mouth.
27
What people have protuberant bellies?
Pregnant woman Some alcoholics - some with liver disease develop ascites Tumor or fatal growth
28
What can cause distension?
``` Six “F”’s Fluid Fat Flatulence Feces Fetus Fatal growths ```
29
What should you inspect the abdomen for?
``` Contour Distension Umbilicus (contour, location, signs of hernia or inflammation) Skin (scars, striae, dilated veins) Symmetry of organs ```
30
How does a tumor affect movement of the abdomen?
That section of the abdomen won't move
31
How can a bruit form in the abdomen?
Atherosclerosis | Abdominal aneurysm
32
How do you auscultate the abdomen?
Listen with diaphragm in all 4 quadrants for 15 seconds Make sure to hear bowel sounds in at least 1 quadrant If you don't hear during the first round, listen again If you don't hear this time, it’s considered absent bowel sounds -> will have other signs and symptoms/complaints (nausea, vomiting, bloating)
33
What is borborygmi
String of bowel sounds | Can be normal of a sign of obstruction
34
What types of sounds can indicate an early intestinal obstruction?
High pitched, tinkling, & splashing
35
How can bowel sounds be categorized?
Normal, absent, hypoactive, or hyperactive
36
When do you see hypoactive bowel sounds?
Seen in someone out of surgery | Someone on narcotics
37
When do you see hyperactive bowel sounds?
Obstruction
38
What are signs of peritonitis?
Guarding Pain Rebound tenderness
39
Where is a venous hum heard?
Liver or upper abdomen
40
What does a venous hum indicate?
Liver disease, hepatic cirrhosis
41
What does it mean when you hear a friction rub over the spleen
Inflammation, or infarction
42
What does it means when you hear a friction rub over the liver?
Primary or metastatic tumor. Causes grating sound.
43
What is the sequence for listening for a bruit in the umbilicus region?
Aorta -> right renal artery -> left renal artery -> go below umbilicus -> right iliac artery -> left iliac artery -> right femoral artery -> left femoral artery
44
How do you percuss the abdomen?
Percuss in all 4 quadrants
45
When is dullness heard?
When percussing over dense abdominal organs, feces, or fluid
46
When is tympany heard?
When percussing over air filled structures | Heard over most of the abdomen because stomach & bowel contain air & gas.
47
How do you measure for the liver border?
Right MCL Percuss down from breast - will hear resonance over lungs Mark with pen when you hit dullness (around 5th or 6th ICS) Go to umbilicus and MCL and start percussing up until you hear dullness - mark with pen Measure Normal size is 6-12 cm
48
Where does the inferior portion of the liver sit?
Right costal margin
49
How do you percuss the kidneys?
Take hand and put upside down over kidney Tap with other hand Percussing for tenderness, not sound
50
What is rebound tenderness?
Not hurting when you press in and hurting when you let go
51
When can rebound tenderness be present?
Peritonitis
52
What is the process of palpating?
Light palpation then deep palpation
53
What is a positive Rovsing sign?
When you press on LLQ and pain is increased on RLQ
54
What could a + Rovsing sign indicate?
Appendicitis
55
What is McBurney's Point and where is it?
Point where the appendix is on the body | ⅓ up from right superior iliac crescent to umbilicus
56
What is a + Murphy's sign?
Intense pain when you hook fingers under right costal margin of right costal angle
57
What can a + Murphy's sign indicate?
Cholecystitis
58
Where is the gallbladder located?
RUQ
59
How do you palpate for the liver?
``` Stand to the right of the pt Put left hand under small of back Go up under right costal margin and put fingers under there Have pt take deep breath Run fingers along right costal margin Cirrhosis of liver will feel ridgey ```
60
How do you palpate for the kidneys?
Go to umbilicus and over to the side Feel from front and back sides Left hand underneath pt and right hand pressing down
61
What does the CVA test look for?
Pyelonephritis, kidney tenderness

Health Assessment final (6 decks)

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