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NURB 3060 > Assessing the Abdomen > Flashcards

Assessing the Abdomen Flashcards

(62 cards)

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1
Q

inspection of the abdomen

A
  • coloration
  • vascularity
  • striae
  • scars
  • lesions and rashes
  • umbilicus
  • location of umbilicus
  • contour of umbilicus
  • contour
  • symmetry
  • respiratory movements
  • aortic pulsations
  • peristaltic waves
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2
Q

normal findings of coloration of skin

A

skin may be paler than the general skin tone because this skin is so seldom exposed to the natural elements.

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3
Q

abnormal findings of coloration

A
  • Purple discoloration at the flanks (Grey–Turner sign) indicates bleeding within the abdominal wall, possibly from trauma to the kidneys, pancreas, or duodenum or from pancreatitis.
  • The yellow hue of jaundice may be more apparent on the abdomen.
  • Pale, taut skin may be seen with ascites (significant abdominal swelling indicating fluid accumulation in the abdominal cavity).
  • Redness may indicate inflammation.
  • Bruises or areas of local discoloration
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4
Q

normals findings of vascularity of abdominal skin

A

-scattered veins may be visible

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5
Q

abnormal findings of vascularity of abdominal skin

A
  • dilated veins, can indicate cirrhosis of liver, obstruction of inferior vena cava, portal hypertension, or ascites
  • dilated surface arterioles and capillaries with a spider angioma, may indicate liver disease or portal hypertension
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6
Q

normal findings of striae

A
  • pink or bluish (new)

- silvery, white, linear, uneven (old, past pregnancies or weight gain)

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7
Q

abnormal findings of striae

A
  • dark bluish-pink, Cushing syndrome

- result of ascites, resulting from liver failure or disease

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8
Q

normal findings of scars

A

pale, smooth, minimally raised

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9
Q

abnormal findings of scars

A
  • non-healing wounds
  • redness
  • inflammation
  • deep, irregular scars from burns
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10
Q

normal findings of umbilicus

A

tone is similar to surrounding skin or even pinkish

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11
Q

abnormal findings of umbilicus

A
  • Cullen sign: bluish or purple discoloration around umbilicus, indicates intra-abdominal bleeding
  • grey-turner sign: bluish or purplish discoloration on the abdominal flanks
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12
Q

normal findings of umbilical location

A

midline at lateral line

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13
Q

abnormal findings of umbilical location

A

-deviated, can be caused from pressure from a mass, enlarged organs, fluid, hernia, or scar tissue

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14
Q

normal findings of umbilical contour

A
  • recessed (inverted), protruding no more than 0.5 cm

- round or conical

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15
Q

abnormal findings of umbilical contour

A
  • everted, seen with abdominal distention

- enlarged and everted suggests umbilical hernia

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16
Q

normal findings of abdominal contour

A

-flat, evenly rounded, or scaphoid (normal in thin adults)

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17
Q

abnormal findings of abdominal contour

A
  • protuberant or distended abdomen, due to obesity, air (gas), or fluid accumulation
  • distention below the bladder, due to full bladder, uterine enlargement, or ovarian tumor or cyst
  • distention of upper abdomen seen with masses of the pancreas or gastric dilation
  • scaphoid, seen with severe weight loss or cachexia (wasting of the body) related to starvation or terminal illness
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18
Q

major causes of abdominal distention

A
  • fat
  • feces
  • fetus
  • fibroids
  • flatulence
  • fluid
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19
Q

how to inspect abdominal contour

A

sit at the patient’s side and look slightly higher than the patient’s abdomen inspecting the area between the lower ribs and pubic bone

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20
Q

normal findings of abdominal symmetry

A

-symmetrical

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21
Q

abnormal findings of abdominal symmetry

A

-asymmetrical, seen with organ enlargement, large masses, hernia, diastasis recti, or bowel obstruction

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22
Q

abnormal findings of respiratory movement

A

diminished or change to thoracic breathing in males, may reflect peritoneal irritation

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23
Q

normal findings of aortic pulsations

A
  • slight pulsation visible in the epigastrium

- extends full length in thin people

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24
Q

abnormal findings of aortic pulsation

A

-vigorous, wide, exaggerated, may be seen with abdominal aortic aneurysm

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25
normal findings of peristaltic waves
- normally not seen | - may be visible in very thin people as slight ripples
26
abnormal findings of peristaltic waves
increased and progress like ripples fro LUQ to RUQ with intestinal obstruction
27
what to auscultate for when assessing abdomen
- bowel sounds - vascular sounds - venous hum - friction rub over liver and spleen
28
normal findings of bowel sounds
- soft clicks and gurgles at rate of 5-30 per minute | - hyperactive bowel sounds (borborygmus), loud prolonged gurgles (stomach growling
29
abnormal findings of bowel sounds
- hyperactive bowel sounds that are rushing, tinkling, and high pitched, indicates rapid mobility heard in early bowel obstruction, gastroenteritis, diarrhea, or laxative use - decreased or absence, indicate no bowel motility, emergency, immediate referral needed
30
how to auscultate for vascular sounds
Use the bell of the stethoscope to listen for bruits (low-pitched, murmur-like sound) over the abdominal aorta and renal, iliac, and femoral arteries -important if client has hypertension or if arterial insufficiency is suspected in legs
31
normal findings of vascular sounds
-bruits not normally heard over abdominal aorta or renal, iliac, or femoral arteries
32
abnormal findings of vascular hum
-bruit with both systole and diastolic components, occurs when blood flow in artery is turbulent or obstructed, may indicate an aneurysm or renal arterial stenosis (RAS)
33
how to listen for venous hum
-use bell of stethoscope and listen in the epigastric and umbilical areas
34
normal findings of venous hum
not heard
35
abnormal findings of venous hum
-accentuated venous hum heard suggests increased collateral circulation between the portal and systemic venous systems, as in cirrhosis of the liver
36
how to auscultate for friction rub over the liver and spleen
use diaphragm and listen over the right and left lower rib cage
37
normal findings of friction rub over liver and spleen
no friction rub present
38
abnormal findings of friction rub over liver and spleen
- heard over the lower right costal area, can be hepatic abscess or metastases. - heard at the anterior axillary line in the lower left costal area, can be splenic infarction, abscess, infection, or tumor.
39
palpation of the abdomen
- tone - span or height of the liver - spleen - liver and kidneys - light palpitation - deep palpitation - massess - umbilicus - aorta - liver - urinary bladder
40
normal findings of tone of the abdomen
- tympany heard over the abdomen due to air in the stomach and intestines - dullness heard over the liver and spleen
41
abnormal findings of tone of abdomen
- accentuated tympany or hyperresonance is heard over a gaseous distended abdomen - enlarged area of dullness, heard over enlarged liver and spleen
42
how to percuss the lower border of the liver
- begin in the RLQ at the midclavicular line and percuss upward - note the change from tympany to dullness, that is the lower border of liver dullness
43
how to percuss the upward border of the liver
- percuss over the upper right chest at the MCL and percuss downward - note the change from lung resonance to liver dullness, that is the upper border of liver dullness
44
how to measure the span of the liver
mark the distance between the upper border and the lower border of the liver
45
normal findings of percussion of the lower border of the liver
dullness located at the costal margin to 1-2 cm below
46
normal findings of percussing the lower border of the liver
on deep inspiration, dullness may descend from 1-4 cm below the costal margin
47
normal findings of percussing the upper border
located between the left fifth and seventh intercostal spaces
48
abnormal findings of percussing the upper border
difficult to estimate due to obscured pleural fluid of lung consolidation
49
normal findings of percussing the span of the liver
- 6-12 cm | - greater in men and taller patients, less in shorter patients
50
abnormal findings of percussing the span of the liver
- hepatomegaly, liver span is enlarged, found in liver tumors, cirrhosis, abscess, and vascular engorgement - span is decreased, due to atrophy of liver - lower in position, may be caused by emphysema - higher in position, may be caused by abdominal mass, ascites, or a paralyzed diaphragm
51
how to percuss the spleen
starting posterior to the left midaxillary line percuss downward noting the change from lung resonance to splenic dullness
52
normal findings of percussing the spleen
-oval area of dullness approx. 7cm wide near the left tenth rib and slightly posterior to the MAL
53
abnormal findings of percussing the spleen
splenomegaly, area of dullness greater than 7 cm wide, may result from traumatic injury, portal hypertension, and mononucleosis
54
how to perform blunt percussion on the liver and kidney
- percuss the liver by placing your left hand flat against the lower right anterior rib cage, use the ulnar side of your right fist to strike your left hand - perform on kidneys at the costovertebral angles on the 12th rib
55
normal findings when percussing the liver and kidneys
no tenderness elicited
56
abnormal findings when percussing the liver and kidneys
tenderness elicited over the liver may be associated with inflammation or infection
57
abnormal findings when blunt percussing the kidney
tenderness or sharp pain suggests kidney infection (pyelonephritis), renal calculi, or hydronephrosis
58
how to do light palpitation
- use fingertips and compress to a depth of 1 cm in a dipping motion - used to identify area of tenderness and muscular resistance
59
normal findings of light palpitation of abdomen
nontender and soft, no guarding
60
abnormal findings of light palpitation of abdomen
- involuntary reflex guarding, reflects peritoneal guarding | - right sided guarding due to cholecystitis
61
normal findings when palpating for masses
no palpable massess
62
abnormal findings when palpating for masses
mass detected, may be due to a tumor, cyst, abscess, enlarged organ, aneurysm, or adhesions

NURB 3060 (3 decks)

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