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Flashcards in abdominal exam Deck (20):
1

How many bowel sounds per minute is normal?

  • 5-35 per minute

 

  • (must listen at least 5 full minutes without hearing BS to document absent BS) 

2

 

trace the flow of bile

Right and Left Hepatic ducts -->

common hepatic duct --> 

joins cystic duct coming from gallbladder to form common bile duct -->

joined by pancreatic duct at ampulla of Vater (aka hepatopancreatic duct or ampulla) --> duodenal papilla

 

3

name the 9 abdominopelvic regions

 

right hypochondriac  -->   epigastric  -->  left hypochondriac

 

right lumbar  -->           umbilical   -->     left lumbar

 

right inguinal/iliac -->  hypogastric (or suprapubic)  -->  left inguinal/iliac

4

What are possible causes of a protuberant abdomen? (the 7 F's)

  • fat
  • feces
  • flatus
  • fluid/ascites
  • fetus
  • fibroid
  • freaking large/fatal tumor

5

describe McBurney's point and McBurney's sign

  • McBurney's point is 1/3 the distance from the Anterior Superior Iliac Spine (ASIS) and the umbilicus
  • Positive McBurney's sign= firm pressure over this point is held for a few seconds, then released quickly. If patient has pain (ie, rebound tenderness), indicates peritoneal irriation (such as from appendicitis) 

6

 

 

Blumberg sign

 

 

rebound tenderness (pain is worse when pressure is released)

7

 

 

Cullen's sign

 

 

peri-umbilical bluish discoloration

indicates intra-abdominal bleeding (eg, ruptured aoritc aneursym, pancreatitis, ruptured ectopic pregnancy, others)

A image thumb
8

 

What does high-pitched, tinkling bowel sounds suggest?

 

Intestinal fluid and air under pressure, as in early obstruction

9

 

List signs of peritonitis

  • limited abdominal movement with respiration, esp in males 
  • Blumberg's sign (rebound tenderness)
  • exquistely tender abdomen to palpation
  • nausea/vomiting
  • board-like abd rigidity (involuntary muscle guarding)
  • diminished/absent bowel sounds
  • + obturator sign
  • + iliopsoas sign
  • + Markle sign
  • + Ballance sign

10

describe liver and splenic friction rubs and what they might mean

  • high-pitched
  • associated with respiration
  • indicate inflammation of the peritoneal surface of the organ due to infection, infarction, or tumor

11

describe a venous hum and indication if heard in abdomen

  • soft
  • low-pitched
  • continuous
  • may occur with increased collateral circulation between portal and systemic venous systems

12

potential causes of pain in the right hypochondriac region

  • hepatitis
  • gallstones/biliary colic
  • right lower lobe pneumonia
  • hepatic rupture
  • gastric ulcers
  • pancreatitis
  • hepatic abscess
  • herpes zoster

13

potential causes of pain in the epigastric region

  • gastritis
  • gastric or duodenal ulcer
  • pancreatitis
  • hepatomegaly
  • hepatitis
  • hepatic rupture
  • myocardial ischemia/infarction
  • GERD
  • cholelithiasis- gallstones
  • AAA- abdominal aortic aneurysm
  • epigastric hernia
  • gastric cancer

14

potential causes of pain in the left hypochondriac region

  • splenic rupture/enlargement/infarction
  • pancreatitis
  • left lower lobe pneumonia
  • gastric ulcer
  • gastritis
  • perforated colon
  • aortic aneurysm
  • MI

15

potential causes of pain in the Right lumbar region

  • right pyelonephritis
  • constipation
  • urinary calculi
  • lumbar hernia
  • regional enteritis
  • small bowel obstruction
  • leaking aneurysm

16

potential causes of pain in the umbilical region

  • umbilical hernia
  • ruptured AAA
  • constipation
  • small bowel intestinal obstruction/ischemia
  • early appendicitis
  • diverticulitis
  • pancreatitis
  • mesenteric thrombosis

17

potential causes of pain in the left lumbar region

  • left kidney pyelonephtritis
  • constipation
  • kidney calculi
  • perforated colon
  • strangulated hernia
  • leaking AAA
  • regional enteritis
  • diverticular disease

18

potential causes of pain in the right inguinal/iliac region

  • Pelvic inflammatory disease
  • Right ovarian abscess/torsion/cyst
  • ectopic pregnancy
  • appendicitis
  • inguinal hernia
  • endometriosis
  • constipation
  • salapingitis
  • ureteral stone
  • meckel diverticulitis
  • perforated cecum

19

potential causes of pain in the hypogastric (suprapubic) region

  • urinary tract infection
  • uterine cramps
  • uterine fibroids
  • pelvic inflammatory disease
  • pregnancy contractions, round ligament pain
  • diverticular disease
  • endometriosis
  • appendicitis

20

potential causes of pain in the left inguinal/iliac region

  • left ovarian abscess, cyst, torsion
  • PID
  • left salpingitis
  • ectopic pregnancy
  • endometriosis
  • hernia
  • leaking aneurysm
  • diverticular disease