Abdominal 2: Abdomen Flashcards
(32 cards)
Inspection
What do you look for?
Asymmetry
Abdominal distension
Scars and striae
Prominent veins - e.g. caput madusae
Hernias
Peristalsis
Cullen’s sign
Grey-Turner’s sign
Stomas
Drains
What are the 5 Fs of abdominal distension?
Fat (obesity)
Faeces (constipation)
Fetus (pregnancy)
Flatus (gastrointestinal)
Fluid (ascites)
What are caput medusae and what are they a sign of?
Distended, engorged umbilical veins radiating from umbilicus across abdomen to join systemic veins.
Sign of severe portal hypertension with portal-systemic shunting through umbilical veins
When is visible peristalsis seen in the abdominal examination?
Chronic pyloric stenosis
Intestinal obstruction
What is Cullen’s sign and what does it indicate?
Bruising around umbilicus
Haemorrhagic pancreatitis
What is Grey-Turner’s sign and what does it indicate?
Bruising in flanks
Haemorrhagic pancreatitis
What to check for when you see a stoma?
Location
Content
Spout
(stoma = spout)
What to check for when you see a drain?
Location
Content
Volume
What is light palpation used to assess?
Tenderness
Guarding
What is involuntary guarding a sign of?
Irritation of the peritoneum
What are the three types of tenderness?
Rebound tenderness
Rovsing’s sign
Murphy’s sign
What is rebound tenderness?
Slowly compress, quickly release
Pain on release
What is Rovsing’s sign?
Palpation of left iliac fossa causes right iliac fossa pain
Classically indicates appendicitis, BUT is a NON-SPECIFIC SIGN
What is Murphy’s sign?
Pain on palpation of gallblader on inspiration
Typically patient will take a sharp gasp if you reach for the right costal margin
What are the four abdominal quadrants?
RUQ
LUQ
RLQ
LLQ
What are the nine abdominal regions?
Right + left hypochondrium
Epigastrium
Right + left flank
Umbilical region
Right + left iliac fossa
Suprapubic region
What is deep palpation used to assess?
Masses
- Location
- Size
- Shape
- Consistency
- Mobility
- Pulsatility
To where does a normal liver extent from?
5th intercostal space
Costal margin
Can the normal spleen be felt?
No
Only palpable if doubled in size - enlarges from under left costal margin towards RIF
Can the normal kidneys be felt?
Not usually except thin individuals
Because they are retroperitoneal
What might a scar in the iliac fossa indicate?
Kidney transplant
What are the things to palpate in an abdominal exam?
Liver
Kidneys
Spleen
Aorta
Bladder
When can the aorta be palpated?
Thin patients
Those with dilated aorta
What does a pulsatile aorta mean?
Hands move upwards with pulsation
Normal in thin people
