Flashcards in Abdominal Lecture Deck (66)
Where does the abdominal cavity extend from?
Just below diaphragm to the symphysis pubis
How are the 4 quadrants of the abdomen drawn?
-Vertical line through umbilicus
-Horizontal across umbilicus
Loss of appetite
What can early satiety indicate?
Gastric outlet obstruction
What GI-related things can cause unintentional weight loss?
How can heartburn radiate?
To neck and epigastrum
Mechanical causes of dysphagia
-Cancer or mass
Motor causes of dysphagia
If a patient points to their throat, they usually have a/an ___ problem
If a patient points to their chest (and it is suspected GI related), then it is often a/an ____ problem
Define transfer dysphagia
-Swallowing is attempted
-Results in aspiration of food into nose/lungs
-Suggests CNS problem
Esophageal musculature does not relax enough
Regurgitation of food bolus suggests ____ problem
Intermittent solid to liquid mechanical dysphagia suggests:
Intermittent solid then progressing to liquid mechanical dysphagia and progressively worsening with pain suggests:
What are common causes of odynophagia?
-Esophagitis (GERD induced)
What is the MC cause of odynophagia?
Sharp and burning odynophagia suggests:
Mucosal inflammation (reflux esophagitis or infection)
Sharp and sticking odynophagia suggests:
Mechanical (fish or chicken bone)
Squeezing/cramping odynophagia suggests:
Muscular (esophageal spasm, achalasia)
Define regurgitation (GI)
Bringing up gastric contents without nausea or vomiting
What can cause fecal-like material to be vomited?
Small bowel blockage or fistula
Presence of bright red blood in vomitus indicates:
Esophageal or upper GI bleed
Presence of coffee ground material in vomitus indicates:
Partially digested blood (altered by stomach acid)
Prolonged vomiting will cause:
Fluid and electrolyte imbalance
Aerophagia can cause:
Constipation occurring as a result of intestinal obstruction
Large volumes of osmotic (watery) diarrhea can indicate:
Soft, watery with blood diarrhea indicates:
IBD (ulcerative colitis)
Small, soft, watery w/o blood diarrhea indicates:
Blood has passed through digestive tract
(black, tarry stools)
Jaundice can be accompanied with:
Jaundice is caused by:
Hepatic disease or lysis of RBCs
Jaundice causes elevated levels of ____ in the blood
How do urine and stool change with jaundice?
-Urine becomes like tea
-Stools become light yellow or gray
Stretching of liver capsule can cause ____ pain
Quality of visceral pain
-Can be related to intestinal peristalsis
-Usually not well localized by pt
Severe visceral pain can be accompanied by:
Function of mesentery
Acts as conduit for BV, nerves, lymphatics usually supported in layers of fat
Describe parietal pain
-Inflammation of parietal peritoneum
-Aka somatic pain
-Steady, aching, severe (worse than visceral)
-Aggravated by movement (pts lie still!)
How does acute appendicitis pain present?
-Initially, periumbilical visceral pain
-Gradually, parietal pain well localized to RLQ as inflammation spreads
Define referred pain
-Pain from original site radiates to distant site
-Often at same spinal level as affected structure
-May be superficial or deep
Abdominal pain is a (reliable/unreliable) guide to severity?
Unreliable - depends on patient
-Chronology may be more useful
How is abdominal contour described?
Visible peristalsis can be an early sign of:
Define diastasis recti
Separation of rectus abdominis muscles in midline creating a ridge when pt lifts head and shoulders off flat surface
Free fluid collection in abdomen
Hyperactive bowel sounds can indicate:
Hypoactive bowel sounds can indicate:
Absent bowel sounds indicate:
Gas produces what note of percussion?
Liquid produces what note of percussion?
Solid produces what note of percussion?
Even more profound dullness than liquid
Areas that contain both gas and fluid will produce what note of percussion?
Lower pitched tympanic
Most notable areas of abdomen for percussion?
-Gastric bubble (LUQ, tympanic)
-Colonic splenic flexure (LUQ, low tympanic)
-Liver (RUQ, dullness)
What does abdominal muscular rigidity indicate?
How are abdominal masses classified?
-Physiologic (pregnant uterus)
What does rebound tenderness indicate?
Presence of peritoneal inflammation
A normal size liver may be palpable up to ___ cm below the ____
3 cm below costal margin (in mid-clavicular line)
Describe a normal liver edge
What is the purpose of the scratch test?
Can help to locate lower liver margin
Where does the spleen lie?
Between left 10th rib (LUQ)
Purpose of psoas sign
-Tests for appendicitis
-Abdominal pain occurs due to inflamed psoas muscle