AbdomenPhysicalExam Flashcards
(89 cards)
1
Q
effortless reflux of digestive enzymes & stomach contents into the mouth
A
regurgitation
2
Q
forceful expulsion of stomach contents out of the mouth
A
vomiting
3
Q
recent, ongoing bleeding or blood-stained vomit
A
hematemesis
4
Q
associated with bile from the intestines ending up in the stomach through an incompetent pyloric sphincter
A
yellow vomit
5
Q
what causes coffee grounds emesis
A
gastric blood that has been coagulated & oxidized by stomach acids and looks like “coffee grounds” floating in vomit
6
Q
steps in producing the normal, brown colored stool
A
- spleen breaks down old & damages RBC’s to produce bilirubin (unconjugated)
- liver further processes bilirubin and excretes it with bile (conjugated)
- Colon bacteria & oxidation convert biliruin to stercobilin which turns stools brown.
7
Q
Black, tarry foul smelling stools
A
melena
8
Q
stool type results from bleeding higher in the gastrointestinal tract
A
black stools (melena)
9
Q
gray or yellow stools
A
steatorrhea
10
Q
what could cause steatorrhea
A
impaired liver function or bile output blockage, malabsorption of fat
11
Q
possible conditions that cause steatorrhea (5)
A
- hepatitis
- cirrhosis
- chronic pancreatitis
- cholecystitis
- gall stones
12
Q
blood streaked stools
A
hematochezia
13
Q
bleeding in the lower GI tract leads to which kind of stool
A
hematochezia
14
Q
common causes of hematochezia (3)
A
- anal fissure
- hemorrhoids
- polyps
15
Q
a combination of blood, mucus, and feces
A
currant jelly stools
16
Q
currant jelly stools are associated with which condition
A
intusseception
17
Q
dark yellow and orange urine is usually due to what
A
dehydration
18
Q
common causes of hematuria
A
UTI’s and kidney stones
19
Q
what causes tea colored urine
A
impaired liver function or bile output blockage which forces bilirubin to be excreted in the urine rather than in the bile
20
Q
a yellow pigment that gives a bruise, urine & jaundiced skin the yellow color
A
bilirubin
21
Q
symptoms suggesting GI problems
A
- difficulty swallowing
- loss of appetite
- indigestion
- nausea and vomiting
- abdominal pain
- diarrhea
- constipation
- discolored stools or urine
22
Q
symptoms suggesting a GU problem
A
- painful urination
- increased, decreased or absence in frequency of urination
- discolored urine
- discharge
- hesitancy or diminished flow
- infertility or other sexual concerns
23
Q
symptoms suggesting gynecologic problems
A
- pain before, during, or after menstruation
- heavy, light, or absent menstrual flow
- vaginal discomfort or discharge
- infertility or other sexual concerns
24
Q
organs in the RUQ
A
- HEPATIC flexure of colon
- liver
- gallbladder
- right adrenal gland
- right kidney
- SI
25
organs in the LUQ
- SPLENIC flexure of colon
- stomach
- body of the pancreas
- spleen
- left adrenal gland
- left kidney
- SI
- abdominal aorta
26
organs in the LRQ
- cecum and appendix
- right ovary and fallopian tube
- right ureter
- small intestines
27
organs in the LLQ
- sigmoid colon
- left ovary and fallopian tube
- left ureter
- small intestines
28
organs of the suprapubic region
- penis and testicles
- urinary bladder and urethra
- vagina and uterus
29
rule-of-thumb which states that further away from the navel a pt points to an area pain more likely it is organic in nature
apley's rule
30
irritation to the underside of the diaphragm may refer pain to where
shoulder
31
abdominal pain that radiates to the left shoulder
kehr's sign
32
underlying problems in abdomen that cause kehr's sign
- splenic rupture
- kidney stone
- ectopic pregnancy
33
intestinal pain usually has which pattern
wave like pattern
34
pain that originates in solid organs has which pattern
constant pain, depending on how frequently the organ is distended
35
Exam procedures of the abdomen are typically performed in which order
- inspection
- auscultation
- percussion
- light and deep palpation
36
patient placement while performing an abdominal exam
supine on table draped with abdomen exposed from xiphoid to pubic hair line with arms by sides and knees bent to relax the abdominals
37
inspection portion of the abdominal exam
- skin tone and texture
- contour
- pulsations
- peristalsis
38
cyanosis around the umbilicus
cullen's sign
39
cullen's sign indicates what
intra-abdominal hemorrhage
40
varying degrees of abdominal distension result from what
the 9 F's
- fat
- fetus
- full bladder
- feces
- flatus
- fluid
- fibroids
- fatal tumor
- false pregnancy
41
accentuated epigastric pulsations greater than 2" in diameter or a pulsating mass suggests
abdominal aortic aneurysm
42
is it normal for peristaltic movements to be visible
no
43
when peristaltic movements are visible, indicates
intestinal obstruction
44
points you should auscultate during an abdominal exam; listen for abnormal bowel, vascular and friction rub
- aortic
- hepatic and splenic
- renal
- iliac
- femoral
45
what can cause increased frequency of bowel sounds
- hunger
- diarrhea (gastroenteritis)
- intestinal irritants (Crohn's disease, ulcerative colitis)
- first 24 hours of an intestinal obstruction
46
what can cause decreased frequency of bowel sounds (no sounds heard for 2 minutes)
- opiates
- coming out of anesthesia
- coming out of abdominal surgery
- undergoing abdominal cancer radiation therapy
- intussusception (dance sign)
47
dance sign indicates what
intussusception
48
absence of sounds in the LRQ
dance sign
49
what can cause a bruit
- stenosis
- compression
- aneurysm
50
friction rubs in the abdomen suggest
inflammation of the peritoneal surface of an organ
51
venous hums in upper quadrants of abdomen suggest
increased collateral circulation between the portal and systemic venous system
52
percussive notes heard over a normal abdomen
tympanic with occasional dull notes
53
large areas of dullness indicate when heard in the abdomen while performing percussion
- enlarged organ
- tumor
- fluid in abdomne
(feces and full bladder are commonly mistaken for masses)
54
when percussing along the right mid clavicular line, when would you hit the inferior border of the liver
no more than 1/2" below the costal margin
55
where you percuss if looking for the spleen
from 6th - 10th ribs just posterior to the mid axillary line
56
where you percuss if looking for gastric air bubble (stomach)
left 6th - 7th intercostal space
57
what note would the gastric air bubble give
tympanic
58
tympanic note heard above diaphragm with recurrent heartburn, indicates
hiatal hernia
59
deep palpation during an abdominal exam
- lower liver border
- spleen enlargement
- kidneys enlargement
- signs of aortic aneurysm
60
localized abdominal tenderness is reported or detected during deep palpation you should focus your palpation to those areas to find the source of the problem
FALSE; those areas should be avoided until other areas have been assessed
61
lumpy liver border suggest
liver cancer
62
hard liver border suggest
cirrhosis of the liver
63
tender liver border suggest
hepatitis
64
tender mass in right midclavicular line suggests
cholecystitis
65
where is McBurney's point
half way between the navel and the right ASIS
66
percussion at McBurney's point causes discomfort in epigastric area
aaron's sign
67
positive aaron's sign indicates
appendicitis
68
cutaneous hypersensitivity to light stimulation at McBurney's point suggests
appendicitis
69
having pt lift their head when supine contracts abdominal muscles; if pain is diminished when lift head it indicates
pain is coming from a deeper source
70
having patient lift their head when supine position contracts the abdominal muscles. if pain doesn't go away when they lift their head it indicates
the pain is coming from a superficial source
71
eliciting a rebound tenderness is a positive ______ sign and is a means of irritating an intestinal structure and overlying peritoneum without poking directly on a potentially infected structure.
blumberg's
72
if rebound tenderness is felt in the LRQ
McBurney's sign and indicates appendicitis
73
If palpation (not rebound) in LLQ causes pain in LRQ it is a positive ______ sign
Rovsing
74
positive Rovsing sign suggest
appendicitis
75
resistance of your hand
iliopsoas muscle test
76
positive iliopsoas muscle test indicates
appendicitis
77
with pt supine lift right thigh off the table and rotate the leg in and out by holding the ankle
obturator muscle test
78
positive obturator muscle test (pain when rotate ankle) indicates
appendicitis
79
have patient raise up on their toes and drop to their heels
markle's heel drop sign
80
least specific sign for appendicitis
markle's heel drop sign
81
Place flat hand over lower right ribcage and tap the hand with the closed-fist, knife-edge of the opposite hand
fist percussion
82
first percussion aggravates original pain it suggests
hepatitis or cholecystitis
83
Place thumb under right ribcage in area of gallbladder, have patient inhale, cessation of inspiration because of increased pain
Murphy's sign
84
murphy's sign indicates
cholecystitis or gallbladder cancer
85
ways to detect ascites (abnormal intraperitoneal fluid) by physical exam
- fluid wave test
- shifting dullness
- puddle sign
86
which and where are fingers positioned during zieman's tridigital hernia examination
- ring finger over the femoral triangle
- middle finger over the external inguinal ring
- index finger over the internal inguinal ring
87
If the liver edge can be felt it should be
smooth, firm & not tender
88
A strong, expansile aortic pulse greater than 1 inch in diameter during deep palpation suggests
abdominal aortic aneurysm (AAA)
89
____ are more accurate at detecting ascites
sonograms
