Assessing the abdomen

Question 1

Liver  Gallbladder  Duodenum
 Head of pancreas
 Right kidney and
adrenal gland
 Hepatic flexure of
colon
 Part of ascending and
transverse colon

Answer 1

Right Upper Quadrant

Question 2

Stomach
 Spleen
 Left lobe of liver  Body of pancreas
 Left kidney and
adrenal gland
 Splenic flexure of
colon
 Part of transverse and
descending colon?

Answer 2

LEFT UPPER QUADRANT

Question 3

Cecum
 Appendix
 Right ovary and tube
 Right ureter  Right spermatic cord

Answer 3

Right Lower Quadrant

Question 4

A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures?

Answer 4

Mesentery

Question 4

 Part of descending
colon
 Sigmoid colon
 Left ovary and tube
 Left ureter  Left spermatic cord?

Answer 4

Left Lower Quadrant

Question 4

A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures. Functions:
o Ingest and digest food
o Absorb nutrients, electrolytes, and water
o Excrete wastes

Answer 4

The Alimentary tract

Question 5

A serous membrane, lines the cavity and forms a protective cover for many of
the abdominal structures?

Answer 5

The Peritoneum

Question 6

Occurs when hollow abdominal organs such as
intestines become distended or contract forcefully or
when the capsule of solid organs such as the liver and
spleen are stretched. Characterized as dull, aching, burning, cramping or colicky?

Answer 6

Visceral Pain

Question 7

Occurs when the parietal peritoneum becomes inflamed, as in appendicitis or peritonitis characterized as a more
severe and steady pain.?

Answer 7

Parietal Pain

Question 7

Occurs at distant sites that are innervated at
approximately the same levels as the disrupted
abdominal organ. This kind of pain travels or refers from
the primary site and becomes highly localized at the
distant site?

Answer 7

Referred Pain

Question 7

Stand on person’s right side and look down on abdomen
 Then stoop or sit to gaze across abdomen
 Your head should be slightly higher than abdomen
 Determine profile from rib margin to pubic bone; contour describes nutritional
state and normally ranges from flat to rounded?

Answer 7

contour

Question 8

Begin in the ___ and proceed clockwise, covering all quadrants?

Answer 8

RLQ

Question 9

there is a series of soft click and gurgles are heard at a rate of ___
per minute?

Answer 9

5-30

Question 10

Hyperactive sounds referred to as ____ may also be heard
indicates/normal sound of the stomach

Answer 10

borborygmus

Question 11

Reflects diminished motility “ileus“, often follows surgery, viral
illness, severe trauma or overwhelming generalized sepsis, such as
with peritonitis?

Answer 11

HYPOACTIVE bowel sound

Question 11

Increased bowel sounds may occur with gastroenteritis, early
intestinal obstruction, or hunger.  High-pitched tinkling sounds, with rushes and tinkles.  Suggest intestinal fluid and air under pressure, as in early
obstruction or phase of ileus resolution?

Answer 11

HYPERACTIVE bowel sound

Question 12

Referring to an inability to hear any bowel sounds after 5 minutes
of continuous listening, are typically associated with abdominal
pain and rigidity…severe ileus or bowel exhaustion with prolonged
bowel obstruction (indicators of a surgical emergency?

Answer 12

ABSENT bowel sound

Question 12

What organ is: Place the left hand flat against the lower right anterior rib cage. Use ulnar side
of the right fist to strike the left hand?

Answer 12

LIVER

Question 13

Percuss the ___ at the costovertebral angles over the 12
the rib?

Answer 13

KIDNEY

Question 13

PALPATION: Stand at the client’s right side and place you left hand under client’s back at the
level of the 11th to 12th rib?

Answer 13

LIVER

Question 14

Palpation: Stand at the client’s right-side reach over the abdomen with the left arm and
place the hand under the posterior lower ribs. Pull up gently. Place you right
hand below left costal margin with the fingers pointing towards the client?

Answer 14

spleen

Question 15

Ask the client to lie on the left side. Hyperextend the right leg of the client.  Normally, there is no pain present  Abnormal: Pin in the RLQ pain () is associated with irritation of the
iliopsoas muscle due to appendicitis (inflammation of the appendix?**

Answer 15

PSOAS SIGN

Question 15

Support the client’s right knee and ankle.  Flex the hip and knee rotate the leg internally and externally.  Normally, there is no presence of abdominal pain
 Abnormal: Pain in the RLQ indicates irritation of the obturator muscle due to
appendicitis or a perforated appendix?

Answer 15

obturator sign

Question 16

PALPATION: Support the right posterior flank with your left hand and
place your right hand in the RUQ just below the costal margin at the MCL?

Answer 16

Kidney

Question 16

Palpate deeply in the LLQ and quickly release pressure  Normally, there is no rebound pain is elicited  Abnormal: Pain in the RLQ during pressure in the LLQ is a positive Rovsing’s Sign?

Answer 16

Referred Rebound tenderness

Question 16

Stroke the abdomen with a sharp object (e.g., broken cotton tipped applicator or tongue blade) or grasp a fold of skin with your thumb and index finger?

Answer 16

Hypersensitivity test

Question 17

Assess RUQ pain of tenderness, which may signal cholecystitis (inflammation of the gallbladder).  Press your fingertips under the liver border at the right costal margin and ask the client to inhale deeply.  Normally, there is no increase pain present  Abnormal: Accentuated sharp pain that cause the client to hold his or her breath (inspiratory arrest) is a positive Murphy’s sign and is associate with acute cholecystitis?

Answer 17

Test for cholecystitis

Question 18

Hard stools in the colon appear as a localized distention. Percussion over the area discloses dullness

Answer 18

feces

Question 19

The abdomen distended with gas may appear as a generalized protuberance or it may appear more localized. Tympany is the percussion tone over the area?

Answer 19

Flatus

Question 19

Obesity accounts for most uniformity protuberant abdomen. The abdominal wall is thick, and tympany is the percussion tone elicited. The umbilicus usually appears sunken

Answer 19

fat

Question 20

Fluid in the abdomen causes generalized protuberance, bulging flanks, and an everted umbilicus. Percussion reveals dullness over fluid (bottom of the abdomen and flanks) and tympany over intestines (top of the abdomen)

Answer 20

ascitic fluid

Question 20

Results from the bowel protruding through a weakness in the umbilical ring. This condition occurs more frequently in infants, but also occurs in adults?

Answer 20

UMBILICAL HERNIA

Question 21

____occurs when the bowel protrudes through a separation between the two rectus abdominis muscles. It appears as a midline ridge. The bulge may appear only when the client raises the head or coughs. The condition is of little significance?

Answer 21

Diastasis Recti

Question 22

An __ occurs when the bowel protrudes through a weakness in the linea alba. The small bulge appears midline between the xiphoid process and the umbilicus. It may be discovered only on palpation?

Answer 22

Epigastric Hernia

Question 22

(splenomegaly) is defined by an area of dullness exceeding 7 cm. When enlarged, the spleen progresses downward and in toward the midline?

Answer 22

ENLARGED SPLEEN

Question 23

An __occurs when the bowel protrudes through a defect or weakness resulting from a surgical incision. It appears as a bulge near a surgical scar on the abdomenAn incisional hernia occurs when the bowel protrudes through a defect or weakness resulting from a surgical incision. It appears as a bulge near a surgical scar on the abdomen?

Answer 23

Incisional Hernia

Question 23

(hepatomegaly) is defined as a span greater than 12cm at the mid-clavicular line (MCL) and greater than 8cm at the midsternal liver (MSL). An enlarged nontender liver suggests congestive heart failure, acute hepatitis, or abscess?

Answer 23

ENLARGED LIVER

Question 24

An enlarged may be due to cyst, tumor or hydronephrosis. It may be differentiated from an enlarged spleen by its smooth rather than sharp edge, the absence of a notch, and tympany on percussion?

Answer 24

ENLARGED KIDNEY

Question 24

An extremely tender, _-___ suggests acute cholecystitis. A positive finding is Murphy’s sign (sharp pain that causes the client to hold the breath)?

Answer 24

ENLARGED GALLBLADDER

Question 25

An enlarged firm, hard, nodular liver suggests cancer. Other causes may be late cirrhosis or syPHILIS?

Answer 25

ENLARGED NODULAR LIVER

Question 26

A prominent laterally pulsating mass above the umbilicus strongly suggests an __. It is accompanied by a bruit and a wide bounding pulse?

Answer 26

AORTIC ANEURYSM