Abdominal & GI Assessment

Question 1

Viscera means

Answer 1

Organs

Question 2

Two categories of viscera

Answer 2

solid and hollow viscera

Question 3

Solid viscera include

Answer 3

liver, spleen, pancreas, kidneys, adrenals, ovaries

Question 4

Hollow viscera include

Answer 4

stomach, gallbladder, small intestine, colon, bladder

they will adjust their shape at different times

Question 5

How many quadrants are in the abdomen?

Answer 5

Right Upper Quadrant
Right Lower Quadrant
left upper quadrant
left lower quadrant

Question 6

Kidneys sit right up against the

Answer 6

peritoneum

Question 7

Digestive organs begin to form at

Answer 7

4 weeks digestion

Question 8

During pregnancy

Answer 8

abdominal muscles lose tone 
stomach displaced upwards
peristaltic activity decreased and water reabsorption increased
hemorrhoid formation occurs 
bladder compression

Question 9

Elderly developmental considerations

Answer 9

Liver size decreases leading to significant altered metabolism of drugs

Question 10

Subjective Data

Answer 10

appetite 
dysphagia 
food intolerance
abdominal pain 
nausea or vomiting 
bowel habits 
past medical history 
past surgical history

Question 11

Patient considerations for the physical exam

Answer 11

warm hands and warm stethoscope. letting them know what you are doing, having a conversation with them while doing assessment

Question 12

Physical Exam inspection - Contour and symmetry

Answer 12

Contour - flat, rounded, protuberant or scaphoid (indented stoma
symmetry

Question 13

Umbilicus

Answer 13

Color should be consistent with body’s color
Central without displacement
may be inverted or protruded slightly
free of inflammation, swelling, or bulges that indicate herniation

Question 14

What is Cullen sign and Grey-Turners sign?

Answer 14

Cullen Sign: Intraperitoneal bleeding

Grey-Turner’s sign: retroperitoneal bleeding (behind the peritoneum)

Question 15

Striae are what ?

Answer 15

stretch marks. this is a normal finding

Question 16

potential causes of abdominal distension

Answer 16

obesity
air or gas
ascites 
ovarian cyst
pregnancy
feces
tumor

Question 17

hernia

Answer 17

an organ breaks through the lining and is displaced

Question 18

Ascites

Answer 18

end up with fluid in the belly - very round. Much more free fluid in the interstitial space that pools in the flanks (sides)
Test with the fluid wave test

Question 19

Striae

Answer 19

Stretchmarks - very common in those who have gained and lost a lot of weight

Question 20

Rebound Tenderness

Answer 20

Test for Appendicitis
press deeply into abdomen, remote from area of discomfort
rapidly withdraw hand and fingers and assess for sharp stabbing pain
normal is no pain on release of pressure

Question 21

In thin persons would it be abnormal to see pulsations of aorta and waves of peristalsis come over the abdomen ?
What about veins on the abdomen?

Answer 21

No, this would be a normal finding especially in thin people.
Veins normally would not show on the abdomen but in particularly thin people they may.

Question 22

Hypoactive bowel sounds could be present when ?

Answer 22

Following abdominal surgery

Peritonitis (inflammation of the peritoneum)

Question 23

What is borborygmus ?

Answer 23

The hyperactive bowel sounds one hears that occurs with the “stomach growling”
This is common finding.

Question 24

A mechanical obstruction is within the abdomen - what kind of bowel sounds would you expect to hear?

Answer 24

Hypoactive either decreased or absent bowel sounds

Question 25

Increased peristalsis and bowel sounds accordingly , are associated with which conditions and use of what kind of medications ?

Answer 25

Diarrhea, laxatives, gastroenteritis

Question 26

What is the normal liver span?

Answer 26

6-12 cm in adults - liver span corresponds with height. Taller people have a greater liver span

Question 27

What is hepatomegaly?

Answer 27

Enlargement of the liver

Question 28

When would an aortic aneurysm be indicated ?

Answer 28

during palpation of aortic pulsation, the examiners thumb and forefinger are pushed wider apart during pulsation.

Question 29

What could an enlarged spleen indicate ?

Answer 29

Possible lymphoma, trauma, leukemia or mononucleosis

Question 30

What are two tests for Ascites specifically ?

Answer 30

Fluid Wave Test and the Shifting Dullness Test

Question 31

If a patient has pain in a specific abdominal area, when would I palpate that area in the physical examination ?

Answer 31

Do this area last

Question 32

What does the Rebound tenderness test assess for ?

Answer 32

A negative Rebound tenderness test would be when upon the release of pressure, there is no pain. Positive would be if there is pain, which indicates inflammation of the peritoneum, which is part of appendicitis symptoms.

Question 33

What organs and structures lie within the Left upper quadrant ?

Answer 33

``` Stomach Body of pancreas Spleen Part of transverse and descending colon left kidney left lobe of liver left adrenal gland ```

Question 34

What does the Iliopsoas muscle test for ?

Answer 34

To test for appendicitis. Have patient raise right leg and hold it as you push down on right upper thigh. Increased abdominal pain occurs with appendicitis

Question 35

What is Murphy's test and what is it used for ?

Answer 35

It is used for cholecystitis (inflammation of the gallbladder) Palpate just under the liver border and have patient take deep breath. Normally this should be done without pain. As patient takes deep breath, the gallbladder would be pushed by the descending liver into your palpating hand.

Question 36

Abdominal pain assessment - parietal pain means ?

Answer 36

Sharp, precisely localized, and aggravated by movement that can occur with inflammation of the peritoneum

Question 37

Abdominal pain assessment - visceral pain means ?

Answer 37

Pain may be visceral from an internal organ - pain characterized as poorly localized, dull and general

Question 38

Abdominal pain assessment - referred pain means ?

Answer 38

Pain that occurs from a disorder in another site. In other words, pain is radiating to the abdominal area.

Question 39

The space between the vertebrae and the 12th ribs is known as

Answer 39

the costovertebral angle (CVA)

Question 40

What kind of percussive abdominal sounds sounds should one hear if a patient has bloating symptoms?

Answer 40

Potentially hyperresonance which occurs with gaseous distension