Abdominal

Question 1

Types of Pain

Answer 1

Visceral Pain
Parietal Pain
Referred Pain

Question 2

Pain

1. _____ – poorly defined and intermittent; dull, aching, burning, cramping, or colicky (distended intestines, capsules of liver or spleen is stretched).
2. _____ – localized; more severe and steady.
3. _____ – traveling pain; primary site to distant site

Answer 2

1. Visceral Pain
2. Parietal Pain
3. Referred Pain

Question 3

Physical Assessment SEQUENCE:

Answer 3

IAPP

Inspection
Auscultation
Percussion
Palpation

Question 4

Purple discoloration of the abdomen flanks due to bleeding within the abdominal wall

Answer 4

GREY TURNER’S SIGN

Question 5

enlarged and distended superficial veins radiating from the umbilicus across the abdomen.

One of the cardinal signs of portal hypertension

Answer 5

Caput medusae

Question 6

Common sign of liver disease; Dilated surface arterioles and capillaries with a central star.

Answer 6

Spider angioma (spider nevus)

Question 7

wide, dark bluish- pink striae (_____)

Answer 7

Cushing syndrome

Question 8

Periumbilical ecchymosis due to intra-abdominal bleeding.

Answer 8

CULLEN’S SIGN

Question 9

What are the 6 F’s (Including the 7th)

Answer 9

Fat
Feces
Fetus
Fibroids
Flatulence
Fluid
FATAL TUMOR

Question 10

Maybe seen with organ enlargement, masses, hernia (protrude muscles), diastasis recti, or bowel obstruction.

Answer 10

Abdominal asymmetry

Question 11

Waves of peristalsis sometimes are visible in very thin people.

Question 12

Bowel sounds systematic progression

Answer 12

RLQ-RUQ-LUQ-LLQ.

Question 13

auscultating bowel sounds

A series of intermittent, soft clicks and gurgles are heard at a rate of 5–30/minute.

Question 14

“_____”/stomach growling

Answer 14

borborygmus

Question 15

“_____” bowel sounds that are rushing, tinkling, and high pitched.

(rapid motility in EARLY BOWEL OBSTRUCTION, gastroenteritis, diarrhea, or with use of laxatives.

Answer 15

Hyperactive

Question 16

“_____” bowel sounds indicate diminished motility.

(paralytic ileus secondary to abd sx, peritonitis, or LATE BOWEL OBSTRUCTION)

Answer 16

Hypoactive

Question 17

Basic Science

Sound waves are better conducted through a solid medium than through an air-filled medium because of the increased concentration of molecules.

1. The more solid a structure, the higher its pitch, the softer its intensity, and the shorter its duration.
2. 2. The more air-filled a structure, the lower its pitch, the louder its intensity, and the longer its duration.

Question 18

Types of Percussion

Answer 18

IMDI
1. Immediate
2. Mediate
3. Direct Fist
4. Indirect Fist

Question 19

1. _____ – Tapping directly on the body surface with fingers to assess underlying structures.
2. _____ – Striking a finger placed on the body to produce sounds that indicate the condition of deeper tissues.
3. _____ – Gently hitting the body with the side of a clenched fist to check for pain or tenderness.
4. _____ – Placing one hand over the body and striking it with a fist to detect organ inflammation or tenderness.

Answer 19

1. Immediate Percussion
2. Mediate Percussion
3. Direct Fist Percussion
4. Indirect Fist Percussion

Question 20

The midclavicular liver span is expected to be _____ cm Liver span correlates with body size and gender; large people and men tend to have larger spans.

Answer 20

6 to 12 cm

Question 21

The midcsternal liver line span is expected to be _____ cm.

Answer 21

4-8 cm

Question 22

The normal liver is identified as an area of dullness to percussion over the right anterior chest between the fifth rib and the costal margin.

Liver - Dull
Lungs - Resonance

Question 23

Enlargement of the liver due to tumors, cirrhosis, abscess, vascular engorgement

Answer 23

HEPATOMEGALY

Question 24

_____ position – may be caused by emphysema.

_____ position – abd mass, ascites, paralyzed diaphragm.

Answer 24

Lower Position
Higher Position

Question 25

With the patient lying supine, begin percussing posterior to the left midaxillary line (MAL), and percuss downward, noting the change FROM LUNG RESONANCE TO SPLENIC DULNESS.

Question 26

The spleen is an oval area of dullness approximately _____ wide near the left tenth rib and slightly posterior to the MAL.

Answer 26

7 cm

Question 27

Sharp pain occurs with inflammation of the kidney or paranephric area. (_____, _____, _____).

Answer 27

(Pyelonephritis, Renal calculi, Hydronephrosis)

Question 28

_____ Inflammation of the kidney _____ Kidney stones/ calcium buildup _____ fluid buildup in the kidney

Answer 28

Pyelonephritis Renal calculi Hydronephrosis

Question 29

✓_____ palpation = less than 1 cm depression to no depression. ✓_____ palpation: = 1 to 2 cm depression in circular motion ✓_____ palpation= With 2.5 to 5 cm depression to feel for deeper organs and structures. ✓_____ palpation= using two hands on each side of the body being palpated.

Answer 29

Light palpation Moderate palpation Deep palpation Bimanual palpation

Question 30

Ballotement Test _____ Method – using a tapping or bouncing motion of the finger pads over the abdominal wall, feel for a floating mass. _____ Method – place one hand under the flank (receiving/feeling hand) and push the anterior abdominal wall with the other hand.

Answer 30

Single-Hand Method Bimanual Method

Question 31

Hold your hand 90 degrees, or perpendicular, to the abdomen. Push down slowly then lift up quickly

Answer 31

Rebound Tenderness (Blumberg Sign)

Question 32

Press deeply and evenly in the left lower quadrant. Drawing the force towards the ileocecal valve. - Pain in the lower right belly when the left side is pressed and vise versa.

Answer 32

Rovsing' Sign

Question 33

With the person supine, lift the right leg straight up, flexing at the hip then push down over the lower part of the right thigh as the person tries to hold the leg up. When the test is negative, the person feels no change.

Answer 33

Iliopsoas Muscle Test

Question 34

Flex the patient’s right thigh at the hip, with the knee bent, and rotate the leg internally at the hip. This maneuver stretches the internal obturator muscle. - Pain in the lower belly when the hip is bent and the leg is turned inward.

Answer 34

Obturator Sign

Question 35

Pain when pressing on the lower right belly (McBurney’s point).

Answer 35

McBurney Sign

Question 36

Pain or the sudden stop of breathing when pressing under the right ribs while the patient inhales. Test for gallbladder inflammation

Answer 36

Murphy's Sign

Question 37

A bluish or purple discoloration around the umbilicus that indicates INTRA-ABDOMINAL BLEEDING.

Answer 37

Cullen's Sign

Question 38

Palpable Spleen

Answer 38

Splenomegaly

Question 39

_____ is the abnormal buildup of fluid in the abdomen, often due to liver disease.

Answer 39

Ascites