Flashcards in Abdomen Tables Deck (89):
Abdominal pain that is poorly localized periumbilical (mild but increasing) then move to RLQ (steady and severe)
Abdominal pain that is in the RUQ and may radiate to the right scapula. Is steady and aching.
Where would someone feel pain with a small bowel obstruction?
Periumbilical or upper abdominal
Where would someone feel pain with a colon obstruction?
Lower abdominal or generalized
What type pain is epigastric or RUQ; may radiate to the right scapula. It is steady, aching and not colicky.
What two types of abdominal pain are steady and deep?
Cancer of the pancreas
What type abdominal pain is felt in the left lower quadrant?
What type pain is felt in the chest or epigastric and has a burning quality?
Where is pain from stomach cancer often felt?
"cardia" and GE junction; also in distal stomach
What type abdominal pain is in the epigastric (may radiate to back) and have a variable quality including gnawing, burning, aching, pressing, hungerlike.
Peptic Ulcer and Dyspepsia
Most cancers of the stomach and pancreas present as?
What type pain is due to a sudden obstruction of the cystic duct or common bile duct by a gallstone?
What type abdominal pain is due to blood supply to the bowel and messentery being blocked or reduced?
What type ulcer is more likely to cause pain that wakes a person up and night and occurs intermittently over a few weeks, disappears, then recurs?
What type pain has a rapid onset over a few minutes to several hours and often recurs.
Alcohol, heavy, or fatty meals often aggravates this type of abdominal pain
leaning forward with trunk flexed might help with these three types of abdominal pain.
Cancer of the pancreas
What type of abdominal pain is not relieved by food or antacids?
Cancer of the stomach
3 reasons constipation can be caused by life styles and habits.
1. Inadequate time or setting for defecation reflex
2. False expectations of bowel habits
3. Diet deficient in fiber
What are the three types of IBS?
1. Predominately diarrhea
2. Predominately constipation
What type of constipation shows signs of bleeding, pencil shaped stools, weight loss?
Cancer of the rectum or sigmoid colon
What type of constipation is due to a large, firm, immovable fecal mass and presents with rectal fullness. Commonly seen in bed-ridden patients.
What are three metabolic conditions that can lead to constipation?
How long does acute diarrhea last for?
Less than or equal to 14 days
How long does chronic diarrhea last for?
Greater than or equal to 30 days
This type of diarrhea is loose to watery often with blood, pus or mucous. It is due to colonization or invasion of intestinal mucosa.
Inflammatory infection (acute diarrhea)
This type of diarrhea is due to infection by virus, preformed bacterial toxins and is watery without blood, pus, or mucous.
Secretory infection (non-inflammatory)
What are drugs that cause drug induced diarrhea?
Soft to watery diarrhea, often containing blood. Due to inflammation of mucosa and submucosa or rectum. Typically extends proximally from the rectum.
Small, soft to loose or water diarrhea. Usually free of blood. Due to inflammation of bowel wall, generally in a skipping pattern.
What is Crohn's disease of the small bowel known as?
What is Crohn's disease of the colon known as?
Diarrhea from lactose intolerance is usually
Watery diarrhea of large volume
Secretory diarrhea can be caused by?
A variety of things: bacterial infection, fat or bile malabsorption
What is the passage of black, tarry (sticky and shiny) stools. Involves a loss of at least 60 mL of blood.
In these disorders, melena usually occurs along with epigastric discomfort.
Gastritis, GERD, peptic ulcer (gastric or duodenal)
In these disorders, melena occurs along with recent ingestion of alcohol, aspirin, or other anti-inflammatory drugs; recent bodily trauma, severe burns, surgery, or increase ICP.
Gastritis or stress ulcers
What are black, nonsticky stools a result of?
Ingestion of iron, bismuth salts, licorice, or even chocolate cookies.
What is the name for red blood in the stools?
Hematochezia with a change in bowel habits and weight loss is often due to what?
What are reddish, but nonbloody stools often due to?
Ingestion of beets
What can cause an increase in urinary frequency?
infection, tumor, foreign body
Infiltration by scar tissue of a tumor
Motor disorder of CNS (stroke)
If polyluria occurs with severe thirst and polydipsisia what hormone might there be a deficiency of?
ADH or the kidensy may be unresponsive to ADH
What are some fluid-retaining , edematous states that can lead to nocturia?
Hepatic cirrhosis with ascites
What type of urinary incontinence is when the urethral spinchter is weakened so an increase in bladder pressure is greater than urethral pressure. Often due to weak pelvis floor in women. In men may follow prostatic surgery.
What type of incontinence is due to detrusor contractions being stronger than normal, small bladder, decreased cortical inhibition of detrusor contractions, hyperexctibatily of sensory pathways, deconditioning of voiding reflexes (frequently voluntary voiding at low volumes)
Name the type of incontinence. Detrusor contractions are insufficient to overcome urethral resistance. Bladder is usually large. Often caused by benign prostatic hyperplasia, or impaired bladder sensation that interrupts the reflex arc (diabetic neuropathy)
Name the type of incontinence. There is a functional inability to get to the toliet in time because of impaired health or environmental conditions. Problems in mobility from weakness, arthritis, poor vision, distant bathroom, etc.
Name the type of incontinence. Due to drugs such as sedative, tranquilizers, anticholinergics, sympathetic blocks, potent diuretics.
Incontinence secondary to medications
In what type of incontinence is a large bladder often found on physical exam.
What type of incontinence has a continuous dripping or dribbling incontinence.
Overflow incontinence (obstruction of bladder outlet)
What type of incontinence has momentary leakage of small amounts of urine with coughing, laughing, sneezing.
What are the three most common ventral hernias?
Umbilical, incisional, epigastric
What is an hernia that protrudes through an operative scar.
What type hernia is a small midline protrusion through a defect in the linea alba that occurs b/w the xiphoid process and the umbilicus.
What is it called when the two rectus abdominis muscles separate and abdominal content form a midline ridge when the patient raises their head and shoulders. Often seen in repeated pregnancies, obesity, and chronic lung disease.
What is a common, benign, fatty tumor that usually occur in the SQ tissue in the abdominal wall. Tumor typically slips out from under your finger when you press on it.
What is the most common cause of a protuberant abdomen?
What is an apron of fatty tissue that may extend below the inguinal ligaments?
A large, solid tumor is usually ______ to percussion. Air-filled bowel is displaced to the periphery.
Gas causes a _______ percussion note.
Distention becomes more marked in what type of bowel obstruction?
What is the most common cause of a pelvic "mass" ?
What part of the abdomen does asitic fluid go to?
The lowest point, producing bulging flanks that are dull to percussion.
In diarrhea of early intestinal obstruction, bowel sounds are ___________.
Bowel sounds are _____________ then _________ in adynamic ileus and peritonitis.
Decreased then absent
What do high-pitched tinkling sounds in teh bowel suggest?
intestinal fluid and air under tension in a dilated bowel.
What do rushes of high pitched sounds coinciding with an abdominal cramp indicate?
What does a hepatic bruit suggest?
Carcinoma of the liver or alcoholic hepatitis
What does an arterial bruits with both systolic and diastolic components suggest?
Partial occlusion of the aorta or large arteries
What is a soft humming noise with both systolic and diastolic components. It indicates increased collateral circulation b/w portal and systemic venous systems, as in hepatic cirrhosis.
What is a grating sound with respiratory variation that indicates inflammation of peritoneal surface of an organ.
What should you suspect when a systolic bruit accompanies a hepatic friction rub?
Carcinoma of the liver
If a person has abdominal wall tenderness, when they raise their head and shoulder while lying down, will the tenderness increase or decrease? What is the tenderness was from a deeper lesion?
Abdominal wall- A persists
Deep lesion B- Decrease
What is pain that is frequently bilateral and is the result of inflammation of the fallopian tubes. Usually maximal just above the inguinal ligaments. Rebound tenderness and rigidity are present.
Which is more severe- tenderness associated with peritoneal inflammation or visceral tenderness.
Tenderness associated with peritoneal inflammation
What type or peritonitis causes exquisite tenderness throughout the abdomen?
With actue cholecysitis- signs are maximal in which quadrant?
What sign can tell you if an individual have acute cholecystitis?
Where is pain with acute pancreatitis usually located?
Epigastric tenderness and rebound tenderness. Abdominal wall may be soft
Pain in the LLQ that often resembles a left-sided appendicitis is typically what?
What can a downward displacement of a liver caused by a low diaphragm be caused by?
In what type individuals does the liver tend to be elongated, making the right lobe easily palpable (Riedel's lobe)
What disorder can produce an enlarged liver with a firm, nontender edge?
Cirrhosis (also caused by hemochromatosis, amyloidosis, lymphoma)
What does an enlarged liver, with a smooth tender edge suggest?
Inflammation (hepatitis), venous congestion (R-sided heart failure)
What does an enlarged liver that is firm and has an irregular edge or surface suggest?
What drugs cause constipation?
opiates, anticholinergic, antacids containing calcium or aluminum
What drugs cause urinary incontinence?
sedatives, tranquilizers, anticholinergics, sympathetic blockers, potent diuretics