abdominal assessment - exam 2 Flashcards
(29 cards)
What should you ask the patient to do prior to abdominal assessment?
empty bladder
Observation- Asymmetries:
the umbilicus should be ______
surface contour; any distention could be bowel obstruction, mass, etc.
swelling or ascites- possibility indicated by an inverted umbilicus
midline
Discoloration -
Jaundice:
Eccymosis:
Vein detention:
jaundice w/ liver dysfunction, ecchymosis indicating bleeding, vein detention indicating liver or vena cava obstruction
Markings such as
scars, rashes, stretch marks
A pulsatile mass may indicate __________________ but is not unusual in lean individuals
abdominal aortic aneurysm
A wavelike motion may indicate intestinal obstruction:
peristalsis
What can indicate an hernia:
sudden bulging w lifting of the head or a cough indicate a hernia
Auscultations should be performed before ___________ and ________ to avoid altering the bowel sounds
percussion and palpation
Utilize stethoscope for ________mins. in each quadrant
2 min.
Bowel Sounds:
—check each quadrant in a one spot T or F?
False- check in multiple spots
What is a normal sound for the bowel?
—-abnormal? (2)
high-pitched clicks and gurgling every 5-10 secs.
non may indicate bowel obstruction, particularly w/cramping
more may indicate overactivity i.e., w/lactotse intolerance
Abdominal Aorta- just ______ of midline and _______ at peri-sternal line
_________indicate turbulent blood flow
left; umbilicus
Bruits
Percussions Procedure:
-hyperextend and apply firm pressure w/ the non-dominant and distal aspect of the middle finger
-Avoid contact w/ any other part of the head
-Position dominant hand close to surface w/ wrist extended
-Strike the non-dominant middle finger quickly and sharply w/ flexed dominant middle finger
-Strike twice
What are normal sounds of percussions?
tympanic or hollow sound over stomach and bowels or more air-filled organs unless one is full of “substance”
Deep________ or lasting _______ over thorax and lung
_______ sound over more solid or dull organs or even tumors
—-ex
resonance; sound
Dull; liver, heart, & diaphragm or spleen
Location of the stomach to perform percussion?
Empty -sound? Full- Sound?
close to the lower left rib cage just inf. sternum
Emtypy- tympanic or hollow ; Full - dull
Mid-clavicular percussion of liver location?
sounds: starts/changes to ….
just above the umbilicus, along the midclavicular line -progress superiorly
starts w/ tympany or hollow sound of bowel —> changes to dullness @ liver for 2.5 to 5 inches
Abnormal sound of mid-clavicular percussion of the liver:
larger area of dullness
Percussion of Spleen:
–Location
–Normal/ Abnormal sound
starts left lower rib cage anterior axillary line
Normal: tympany or hollowness should be produced; move posteriorly toward mid-axillary line —–> dull (present between 9th and 11th ribs)
Abnormal: dullness noted more medially and inferiorly, more dullness while inspiring.
Kidney percussion (Murphy Test ) in sitting or prone with a firm
fist thumping on the contralateral flat hand over costovertebral angle looking for P!
Kidney palpations you should start with:
-hand placement:
-be sure to look for _______ & _______
-Normal feel:
firm, light pressure in a slow circular fashion within each quadrant
broad hand contact, and possibly palpate through the patient’s hands
masses & mm. guarding
pressure
Kidney palpations
Abnormal feel:
–confirm by doing:
–progress to:
–crepitus or crunchiness indicate ______
tenderness or muscle gauding may indicate swelling or dysfunction
confirm for a similar response with percussion or cough
progress to rebound tenderness if necessary by applying pressure then quickly release
excess air
Hernia is common around the umbilicus and inguinal areas. T or F
True
Notable areas of potential swelling during palpation:
Gastritis (stomach inflammation)
Diverticulitis (intestinal inflammation)
Appendicitis (appendix inflammation)
Hepatitis (liver inflammation)
Pancreatitis (pancreas inflammation)
Spleen
