Abdominal Examination Flashcards
(21 cards)
General inspection
Color, perspiration, build, discomfort, breathing (rate, diaphragmatic or chest wall breathing?), conscious level
What on hands would suggest anaemia
Pallor of palmar creases
What could palmar erythema be due to?
CLD - increased circulating oestrogens
GI causes of clubbing
hepatic cirrhosis
UC
Crohn’s disease
Coeliac disease
What are small isolated white patches or striae in the nail plates called?
Leukonychia (either partialis or totalis)
What nail change could hypoalbuminaemia cause?
Leukonychia totalis or Terry’s nails
Name for spoon shaped nails? And suggests what?
Koilonychia
Chronic iron-deficiency
Single central arteriole with radiating dilated capillaries
Spider navei
What do multiple spider navei suggest?
underlying LD with increased circulating oestrogen
Where do 99% of spider navei occur?
upper trunk, head, neck and arms
Fibrosis + shortening or the palmar aponeurosis
Dupuytren’s contracture
Familial
? trauma, diabetes, alcoholism and LD
Examination for liver flap
Hyperextend wrists, close eyes, 15 seconds (5 for OSCE)
Coarse liver flap (asterixis) suggests…?
liver failure with failure of ammonia metabolism to urea
Where else can asterixis be seen?
Renal failure and in resp failure with CO2 retention
What would forearm muscle wasting suggest?
malnourishment
What would suggest pruritus?
scratching on forearms
Ask pt to do what so you can examine eyes?
Pull their eye down for you
How to check for jaundice (eyes)
Ask pt to lift upper eye. Check sclera
What would subjunctival pallor suggest?
Anaemia. (the tissue thats normally red!!)
Soft or hard yellow patches on inside corners of eyelids
xanthelasma
suggests high cholesterol
Corneal arcus/ arcus senilis
Suggests hypercholesterolaemia
White grey or blue opaque ring in the corneal margin