Assessment of Abdomen Flashcards
(154 cards)
1
Q
Begins digestion through chewing, salivating, and swallowing
A
Mouth
2
Q
Provides sense of taste
A
Tongue
3
Q
Parotid, sublingual and submandibular glands purose?
A
Produce saliva
4
Q
Keeps food and fluid from being aspirated into the airway (trachea) by closing over the larynx when food is swallowed.
A
Epiglottis
5
Q
Pharynx consists of the
A
naso-pharynx
oropharynx
laryngopharynx
6
Q
Allows the passage of food from the mouth to the esophagus
A
Pharynx
7
Q
Assists in swallowing
Secretes mucus, which aids digestion
A
Pharynx
8
Q
Moves food from the pharynx to the stomach using ____.
A
peristalsis
9
Q
Hollow, muscular tube that’s approximately 10” (25.5 cm) long
A
Esophagus
10
Q
Dilated, saclike structure that lies obliquely in the left upper quadrant
A
Stomach
11
Q
Stomach’s sphincters
A
cardiac sphincter
the pyloric sphincter
12
Q
the sphincter, which protects the entrance to the stomach.
A
cardiac sphincter
13
Q
a sphincter, which guards the exit of the stomach.
A
the pyloric sphincter
14
Q
True or False: The stomach stores food and mixes it with gastric juices, then passes chyme into the small intestine for further digestion and absorption.
A
True
15
Q
an Accordion-like folds in the stomach lining and allows stomach to expand.
A
Rugae
16
Q
Small intestine, Consists of the:
A
duodenum
jejunum
ileum
17
Q
Location of carbohydrate, fat, and protein breakdown and absorbs the end products of digestion..
A
Small Intestine
18
Q
Fingerlike projection that’s attached to the cecum
A
Vermiform appendix
19
Q
Large intestine, Consists of the:
A
cecum; ascending, transverse, descending.
sigmoid colons; rectum; and anus
20
Q
Which organ in the digestive system absorbs excess water and electrolytes, stores food residue, and eliminates waste products in the form of feces?
A
Large Intestine
21
Q
_____ normally remains closed to prevent the reflux of gastric contents and opens during swallowing, belching, and vomiting.
A
The gastroesophageal sphincter
22
Q
After food enters the stomach, it remains there for approximately how many hours before moving on to the small intestine?
A
3 or 4 hours
23
Q
Secretes bile, a greenish fluid that helps digest fats and absorb fatty acids, cholesterol, and other lipids and gives stools their color.
A
Liver
24
Q
what organ converts ammonia to urea for excretion?
A
Liver
25
Which organ metabolizes carbohydrates, fats, and proteins, detoxifies blood, and synthesizes plasma proteins, nonessential amino acids, vitamins, and essential nutrients?
Liver
26
Stores bile from the liver until the bile empties into the duodenum.
Gall Bladder
27
What is the typical length range of the pancreas, measuring from approximately ____________ to ____________?
611 to 8" (15 to 20.5 cm)
28
Releases insulin and glycogen into the loodstream and produces enzymes that aid in digestion.
Pancreas
29
Enumerate the components of the bile ducts:
Hepatic ducts: drain bile from the liver
Cystic duct: drains bile from the gallbladder
Common bile duct: receives bile from the hepatic and cystic ducts and empties bile into the duodenum
30
drain bile from the liver
Hepatic ducts
31
drains bile from the gallbladder
Cystic duct
32
receives bile from the hepatic and cystic ducts and empties bile into the duodenum.
Common bile duct
33
RUQ
* Right lobe of the liver
* Gallbladder
Pylorus
* Duodenum
■ Head of the pancreas
■ Hepatic flexure of the colon
■ Portions of the transverse
and ascending colon
34
LUQ
* Left lobe of the liver
* Spleen
* Stomach
■ Body and tail of the
pancreas
■ Splenic flexure of the colon
■ Portions of the transverse
and descending colon
35
RLQ
* Cecum and appendix
■ Portion of the ascending
colon
36
LLQ
■ Sigmoid colon
■ Portion of the descending
colon
37
When considering health history, what factor should be taken into account regarding the patient's background, especially in relation to conditions such as gastric cancer and Crohn's disease?
Ethnic background
38
how to obtaining a health history
*Asking about past health
*Asking about current health
✓Gnawing problems
✓Travel plans
*Family history
*Asking about psychosocial health
39
Family history: Disorders with a familial link include:
✓ulcerative colitis
✓colorectal cancer
✓peptic ulcers
✓gastric cancer
✓alcoholism
✓Crohn’s disease
40
What are some key steps to ensure patient comfort and relaxation during abdominal assessment?
Ask the patient to empty their bladder.
Drape the genitalia and, if applicable, the breasts of female patients.
Place a small pillow under the patient’s knees to relax the abdominal muscles.
Instruct the patient to keep their arms at their sides.
Maintain a warm room temperature to prevent muscle tension.
Warm your hands and the stethoscope head.
Speak softly and encourage the patient to use breathing exercises or imagery for comfort.
Have the patient point to any areas of pain.
Assess painful areas last to minimize muscle tension.
Ask the patient to empty their bladder.
Drape the genitalia and, if applicable, the breasts of female patients.
Place a small pillow under the patient’s knees to relax the abdominal muscles.
Instruct the patient to keep their arms at their sides.
Maintain a warm room temperature to prevent muscle tension.
Warm your hands and the stethoscope head.
Speak softly and encourage the patient to use breathing exercises or imagery for comfort.
Have the patient point to any areas of pain.
Assess painful areas last to minimize muscle tension.
41
What are the steps for abdominal assessment, particularly focusing on palpation and observation?
Palpate the abdomen, checking for tenderness, lumps, dullness, or masses.
Note the patient's abdominal shape and contour.
Assess the umbilicus, which should be inverted and located in the abdominal midline.
42
Identification Question:
What does the presence of visible rippling waves of peristalsis in the abdomen potentially signal, and what action should be taken if such a finding is observed?
It may signal a bowel obstruction, and such a finding should be reported immediately.
43
Abdomen Shape
Normal
Pregnancy
Ascites
Fatty Abdomen
44
When auscultating for vascular sounds in the abdomen, what technique should be used, and which arteries should be listened to using firm pressure with the bell of the stethoscope?
Answer: Auscultate over the aorta, renal, iliac, and femoral arteries using firm pressure with the bell of the stethoscope.
45
During auscultation of the abdomen, where should the diaphragm of the stethoscope be placed, and in what pattern should auscultation be performed in each quadrant?
Lightly place the diaphragm of the stethoscope in the RLQ, slightly below and to the right of the umbilicus. Auscultate in a clockwise fashion in each of the four quadrants.
46
is a vascular sound similar to a heart murmur caused by turbulent blood flow through a narrowed artery
bruit ha ha
47
A bruit is a vascular sound similar to a heart murmur caused by turbulent blood flow through a narrowed artery. It may be heard in patients with what condition(s)?
hypertension or arterial stenosis, occasionally limited to systole in the epigastric region.
48
Why is percussion of the abdomen contraindicated in patients with a suspected abdominal aortic aneurysm or a transplanted abdominal organ?
Percussion can dislodge blood clots in an aneurysm or damage a transplanted organ, potentially leading to rupture or rejection.
49
when percussing the abdomen, it describes two techniques for percussing the abdomen: direct and indirect. What is the purpose of using percussion on the abdomen?
to detect the size and location of abdominal organs,
the presence of air or fluid within the abdomen, stomach, or bowel.
50
A clear, hollow sound similar to a drum beating heard during abdominal percussion indicates what?
Tympany, which suggests air-filled organs like an empty stomach or bowel.
51
A dull sound heard during abdominal percussion suggests what lies beneath the percussed area?
Solid organs like the liver, kidney, or feces-filled intestines.
52
During abdominal percussion, a dull sound is heard over the liver instead of a clear, hollow drum-like sound. Considering tympany indicates air, what likely lies beneath this area?
This dull sound suggests a solid organ like the liver itself, rather than an air-filled organ like the stomach or intestines.
53
What sound indicates the upper border of the liver during percussion?
A change from a clear, hollow sound (resonance) to a dull sound.
54
Where do you start percussing to locate the upper border of the liver?
In the right midclavicular line, within the area where a lung sound (resonance) is heard.
55
How do you locate the lower border of the liver?
Starting below the umbilicus in the right midclavicular line, percuss upwards until the sound changes from a hollow sound (tympany) to a dull sound.
56
What does the distance between the upper and lower borders represent?
This distance represents the liver span.
57
What is considered a normal liver span in adults based on this method?
A normal liver span in adults ranges from 2½" to 4¾" (6.5 to 12 cm)
58
How can you estimate liver size.
By measuring the distance between two marks made during liver percussion.
59
What's the normal liver span in adults for each percussion location?
Midsternal line:
Right midclavicular line:
Midsternal line: 4-8 cm
Right midclavicular line: 6-12 cm
60
Compare the measured distance to the normal range for the assumed percussion location (midsternal or right midclavicular line).
Within normal range: If the distance falls within the expected range, the liver size is likely normal based on this technique.
Outside normal range: If the distance is less than the expected range, the liver may be smaller than usual. If it's greater, the liver may be enlarged.
61
Spleen Location:
The spleen is situated around the 10th rib in the left midaxillary line (referring to the left side, midway between the armpit and hip).
62
Percussion Findings: Percussion may produce a small area of dull sound over the spleen, in what size
typically less than 7 inches (17.8 cm) in adults.
63
True or False: Percussion is a reliable method for accurately assessing the size and health of the spleen.
False
64
True or False: Percussion may produce a small area of dullness over the spleen in adults.
True
65
True or False: The air-filled colon can sometimes make it difficult to hear the dull sound from the spleen during percussion.
True
66
True or False: The dullness produced by the spleen can be difficult to distinguish from the dullness of the back muscles.
True
67
Where do you typically start percussing for the spleen?
In the left anterior axillary line, at the lowest intercostal space (space between ribs).
68
What sound would you normally expect to hear during percussion in this area?
A tympanic sound, which is a clear, hollow sound similar to a drum beat.
69
How can percussion potentially indicate an enlarged spleen?
If the area normally producing a tympanic sound changes to a dull sound when the patient takes a deep breath (inspires), it may suggest an enlarged spleen.
70
Is percussion a definitive method for measuring spleen size?
outlining the spleen's edges with percussion (which would require further explanation), but this wouldn't be a highly accurate measurement technique.
71
How should you position the fingers of your hand for light palpation?
The fingers should be close together.
72
Approximately how deep should you depress the skin during light palpation?
About 1/2 inch (1.5 cm).
73
hat kind of movements should you use during light palpation?
Gentle, rotating movements.
74
What type of movements should you avoid during light palpation?
Short, quick jabs.
75
How much pressure is applied during deep palpation of spleen?
The passage states 2" to 3" (5 to 7.5 cm).
76
How should you perform deep palpation on an obese patient?
Use two hands stacked on top of each other to apply the necessary pressure.
77
n what direction should you palpate the entire abdomen during spleen deep palpation?
Clockwise direction.
78
Spleen: What are you feeling for during deep palpation?
The passage lists several things to check for during deep palpation:
Tenderness
Pulsations
Organ enlargement
Masses
79
What is the expected consistency of the abdomen during deep palpation?
Soft and nontender.
80
What else should you take note of while palpating the four quadrants of the abdomen?
Presence of organs
Masses
Areas of fluid accumulation
Areas of tenderness or increased resistance
81
How can you differentiate between different causes of increased resistance during palpation?
considering if the increased resistance might be due to:
The patient being cold
Tense
Ticklish OR
Involuntary guarding or rigidity from muscle spasms or peritoneal inflammation
82
about Method 1 for palpating the liver:
How does the examiner position themself in relation to the patient?
Answer: The examiner stands at the patient's right side.
83
How are the examiner's hands positioned for palpating the liver?
Left hand: Placed under the patient's back at the approximate location of the liver.
Right hand: Fingers pointing towards the patient's head, slightly below the previously marked upper border of the liver, positioned just under the right costal margin (edge of the ribs).
84
During an abdominal examination of the liver, there are various techniques used for palpation, What is the alternative method for palpating the liver.
Hoooking
85
The alternative method for palpating the liver is called hooking. Here's how the examiner positions their hands:
Examiner Position: Stand next to the patient's right shoulder, facing their feet.
Hand Position: Place both hands side-by-side, with fingertips hooked over the patient's right costal margin (edge of the ribs).
86
True or False?
You should palpate a rigid abdomen during examination.
False, cause pain or
rupture an inflamed organ.
87
What visible sign might indicate an abdominal aortic aneurysm?
Visible pulsations in the abdomen.
88
Why is it important to avoid palpating a suspected abdominal aortic aneurysm?
Palpation of a suspected aneurysm carries the risk of rupture.
89
What should the examiner inspect visually during the initial examination of the anus and surrounding area?
The examiner should check for the following:
Fissures (tears)
Lesions (abnormalities)
Scars
Inflammation
Discharge
Rectal prolapse (protrusion of the rectum)
Skin tags
External hemorrhoids
90
Why does the examiner ask the patient to strain during the examination?
The examiner asks the patient to strain as if having a bowel movement to reveal potential internal structures not visible during rest.
91
The straining may reveal:
Internal hemorrhoids
Polyps (growths)
Fissures (tears)
92
At what age should individuals undergo a rectal examination?
Individuals aged 40 or older should undergo a rectal examination.
93
What preparation should be done before inserting a finger into the rectum during palpation?
A water-soluble lubricant should be applied to the gloved index finger.
94
What instructions are given to the patient during rectal palpation to allow for better examination?
The patient is asked to relax and bear down as the sphincter opens, allowing for gentle insertion of the finger.
95
What should be examined on the glove after removing the finger from the rectum?
The glove should be inspected for stool, blood, and mucus.
96
What potential issue might a guaiac test be used for after a rectal examination?
"The guaiac test" can be used to check fecal matter adhering to the glove for the presence of occult blood (hidden blood not visible to the naked eye). This could be a sign of potential gastrointestinal issues.
97
What physical signs might suggest the presence of ascites?
A protuberant (bulging) abdomen with bulging flanks.
98
Why is percussion used to assess ascites, and what does it look for?
Percussion is used because ascitic fluid accumulates in the dependent areas of the abdomen (areas that become lowest when lying down). Percussion helps distinguish between fluid (dull sound) and gas-filled intestines (tympanic sound).
99
How does the percussion technique map the extent of ascites?
The examiner percusses outward from the center of the abdomen, listening for the transition from a tympanic sound (gas) to a dull sound (fluid). This helps map the borders of the fluid accumulation.
100
How does the "shifting dullness" test help confirm ascites?
The examiner compares the location of the dullness-tympany border with the patient lying supine and then on their side. In a person without ascites, this border should remain relatively constant. However, with ascites, the fluid will shift with the body position, causing the dullness border to move significantly.
101
How is the patient positioned and what does the assistant do during the fluid wave test for ascites?
The patient lies supine (on their back). The assistant places the ulnar edge (bony side) of their hand firmly on the patient's midline, pressing down on the abdomen.
102
How is the fluid wave test performed, and what does a positive result indicate?
The examiner stands facing the patient's head and places their palm on the patient's right flank. A firm tap is delivered to the left flank with the other hand. If ascites is present, a visible and palpable wave will travel across the abdomen due to the fluid (like a ripple effect).
103
a specific location for tenderness during palpation, potentially indicating appendicitis. What is the name of this location, and how is it described?
The location is called McBurney's point. It is described as being two inches (5 cm) from the anterior superior iliac spine (bony prominence on the hip bone) on a line drawn from that point to the umbilicus (belly button).
104
How is the patient positioned for palpation to elicit rebound tenderness at McBurney's point?
The patient is positioned supine (on their back) with knees flexed to relax the abdominal muscles.
105
How is McBurney's point palpated to assess for rebound tenderness, and what does a positive result indicate?
Palpation: Apply gentle pressure at McBurney's point, located midway between the umbilicus and anterior superior iliac spine.
Positive Result: Pain upon releasing pressure indicates rebound tenderness, potentially signifying appendicitis.
106
How can it be challenging to elicit rebound tenderness in young children during abdominal examination?
Young children who are unable to verbalize their pain can make it difficult to assess rebound tenderness through palpation (pushing on the abdomen).
107
What is Rovsing's sign, and how does it potentially indicate appendicitis?
Rovsing's sign is a clinical finding where pressing on the left lower quadrant (LLQ) of the abdomen causes pain in the right lower quadrant (RLQ). This pain in the RLQ (where the appendix is located) suggests possible appendicitis.
108
How is the iliopsoas sign tested?
The patient lies supine with straight legs. They are instructed to raise their right leg while the examiner applies gentle downward pressure on the thigh. This is repeated with the left leg.
109
Positive Result: Increased abdominal pain during this maneuver in either leg suggests irritation of the psoas muscle.
iliopsoas sign
110
Obturator Sign:
Question: How is the obturator sign tested?
Answer: The patient lies supine with their right leg bent at a 90-degree hip and knee flexion. The examiner holds the leg at the knee and ankle, then rotates the leg inwards (medially) and outwards (laterally).
111
Obturator Sign, Positive Result:
Pain in the lower abdominal region (hypogastric region) indicates irritation of the obturator muscle.
112
How does Murphy's sign indicate acute cholecystitis (inflammation of the gallbladder)?
During a physical examination, if the patient stops inhaling and winces with a gasp when the examiner palpates the right upper quadrant of the abdomen during deep inspiration, this is a positive Murphy's sign. This suggests pain caused by the inflamed gallbladder coming into contact with the palpating hand.
113
What is abdominal pain a potential indicator of?
Abdominal pain can be a sign of various conditions, including ulcers, intestinal obstruction, appendicitis, cholecystitis, peritonitis, and other inflammatory disorders.
114
What is an example of specific pain location and timing that might suggest a duodenal ulcer?
a duodenal ulcer can cause gnawing abdominal pain in the midepigastrium (upper middle abdomen) 1 ½ to 3 hours after eating.
115
When assessing abdominal pain, what are some types of pain
Burning pain
Cramping pain
Severe cramping pain
Stabbing pain
116
Could indicate peptic ulcer or gastroesophageal reflux disease.
Burning pain
117
Might be caused by biliary colic, irritable bowel syndrome, diarrhea, constipation, or flatulence.
Cramping pain
118
Possible causes include appendicitis, Crohn's disease, or diverticulitis.
Severe cramping pain
119
May suggest pancreatitis or cholecystitis.
Stabbing pain
120
Types of Abdominal Pain:
Visceral pain: This is a dull, aching discomfort often originating from organs with smooth muscle walls (stomach, intestines). The pain may be poorly localized.
Parietal pain: This is a sharp, well-localized pain arising from the irritation of the abdominal wall lining (peritoneum).
Referred pain: This pain is felt in a different location from the actual source of the problem. Nerves carrying pain signals from the organs can sometimes "mistakenly" send those signals to other areas of the body.
121
can cause visceral pain initially felt around the belly button (periumbilical area), followed by sharp, localized pain in the right lower quadrant (parietal pain).
Appendix: Appendicitis
122
Inflammation of the pancreas can cause both visceral and parietal pain in the upper middle and left upper abdomen, with possible referred pain radiating to the back and left shoulder.
Pancreatitis
123
Which organ is associated with visceral pain in the midepigastrium, parietal pain in the right upper quadrant, and referred pain in the right subscapular area?
Which organ is linked to visceral pain in the periumbilical area, parietal pain over the affected site, and rare referred pain in the midback?
Gallbladder
Small intestine
124
What organ exhibits visceral pain in the periumbilical area, parietal pain in the right lower quadrant, and referred pain also in the right lower quadrant?
Which organ shows visceral pain in the periumbilical area and right flank, parietal pain over the affected site, and referred pain in the right lower quadrant?
Appendix
Proximal colon
125
Identify the organ characterized by visceral pain in the hypogastrium and left flank, parietal pain over the affected site, and referred pain in the left lower quadrant?
What organ presents visceral pain in the midepigastrium, parietal pain in the left upper quadrant, and referred pain in the back and left shoulder?
Distal colon
Pancreas
126
Which structure is associated with visceral pain in the costovertebral angle, parietal pain over the affected site, and rare referred pain in the groin; scrotum in men, and labia in women?
Identify the organs linked to visceral pain in the hypogastrium and groin, parietal pain over the affected site, and referred pain in the inner thighs.
Ureters
Ovaries, Fallopian Tubes, and Uterus
127
What are some potential causes of abdominal distention listed in the passage?
Gas
Tumor
Colon filled with feces
Incisional hernia (protruding when the patient lifts their head and shoulders)
128
How can an incisional hernia contribute to abdominal distention?
occurs when abdominal contents protrude through a weakened area in the abdominal wall, can cause distention, especially when the patient performs specific actions like lifting their head and shoulders. This is likely because the weakened area allows for bulging of the contents.
129
Found in any quadrant and attributed to diarrhea, laxative use, or early intestinal obstruction
Hyperactive sounds (unrelated to hunger) -
130
Present in any quadrant and indicative of paralytic ileus or peritonitis.
Hypoactive (then absent sounds) -
131
Heard in any quadrant and caused by intestinal fluid and air under tension in a dilated bowel.
High-pitched tinkling sounds
132
Observed in any quadrant and suggestive of intestinal obstruction
High-pitched rushing sounds coinciding with abdominal cramps
133
Abdominal aortic stenosis is a narrowing of the abdominal aorta. Besides the abdominal aorta, which other arteries could potentially produce systolic bruits if narrowed?
Renal artery (renal artery stenosis)
Femoral artery (arterial insufficiency in the legs)
134
What are some possible causes of a systolic bruit heard over the abdominal aorta or its branches?
Answer: A systolic bruit over the aorta or its branches (renal or common iliac arteries) could indicate partial arterial obstruction, turbulent blood flow, or specific conditions like renal artery stenosis (narrowing of the renal artery) or hepatomegaly (enlarged liver)
135
What is a rare finding during abdominal auscultation, and what might it indicate?
Answer: A friction rub heard over the liver or spleen (rare) might suggest inflammation of the peritoneal surface of the organ. This could be caused by a tumor on the liver or an infarct (blockage of blood flow) on the spleen.
136
Heard in the epigastric and umbilical regions, it might indicate increased collateral circulation between portal and systemic venous systems, which can occur in cirrhosis.
Venous hum
137
Heard over the liver and spleen, it might suggest inflammation of the peritoneal surface of the organ due to a tumor or infarct.
Friction rub
138
What is a potential health concern associated with cutaneous spider angiomas?
that cutaneous spider angiomas, which are dilated capillaries or arterioles, may be a sign of liver disease.
139
What does Cullen's sign indicate, and where is it typically observed?
Cullen's sign signifies intra-abdominal hemorrhage (bleeding within the abdomen). It appears as a bluish discoloration of the skin around the navel (periumbilical area).
140
Why might Cullen's sign be difficult to detect in some patients?
Answer: The passage mentions that Cullen's sign may be challenging to identify in dark-skinned individuals. This is because the bluish discoloration might be less noticeable on darker skin tone
141
is a bruise-like discoloration of the skin on the flank (area between the last rib and hip bone).
Grey Turner's sign
142
how does Grey Turner's sign, and it potentially indicate acute pancreatitis?
This sign typically develops 6 to 24 hours after the onset of bleeding behind the peritoneum (retroperitoneal hemorrhage), which can be a complication of acute pancreatitis.
143
How can Grey Turner's sign and Cullen's sign indicate acute hemorrhagic pancreatitis?
Answer: Both Grey Turner's sign (flank discoloration) and Cullen's sign (periumbilical discoloration) can be signs of acute hemorrhagic pancreatitis. These discolorations occur because blood from the bleeding pancreas travels to the skin in these areas.
Both Grey Turner's sign (flank discoloration) and Cullen's sign (periumbilical discoloration) can be signs of acute hemorrhagic pancreatitis. These discolorations occur because blood from the bleeding pancreas travels to the skin in these areas.
144
What is a common implication of bloody stools (hematochezia), and what are some potential causes mentioned in the passage?
Answer: Bloody stools can indicate gastrointestinal (GI) bleeding. Several possible causes, including colorectal cancer, colitis, Crohn's disease, anal fissures, and hemorrhoids.
145
What does Melena (black, tarry stools) suggest, and how does it differ from bloody stools (hematochezia)?
Melena indicates significant upper GI bleeding (>60 mL), with blood appearing black due to breakdown during its slower passage.
146
suggests lower GI bleeding with fresh red or maroon blood.
Hematochezia
147
What can cause black stool, and is it indicative of a pathological condition?
Answer: Black stool can result from ingestion of substances like iron, bismuth salts, licorice, or even chocolate cookies. However, when black stool occurs from these causes with negative fecal blood tests, the stool change typically has no pathological significance.
148
Difficulty passing stools or infrequent bowel movements. Symptoms include abdominal discomfort and fullness. Possible causes include immobility, sedentary lifestyle, medications, and Crohn's disease, where it may indicate bowel obstruction.
Constipation
149
Frequent, loose stools with symptoms of abdominal cramping and, in some cases, bloody stool. Possible causes include immobility, sedentary lifestyle, medications, and Crohn's disease, where it can result from inflammation or other gastrointestinal issues.
Diarrhea
150
which is difficulty swallowing, may be accompanied by weight loss. It can result from an obstruction, achalasia of the lower esophagogastric junction, or neurological diseases such as stroke or Parkinson's disease. Dysphagia can lead to aspiration and pneumonia.
Dysphagia
151
often occurring simultaneously, can stem from various underlying illnesses such as myocardial infarction, gastric and peritoneal irritation, appendicitis, bowel obstruction, cholecystitis, acute pancreatitis, bulimia nervosa, and neurological disturbances. Additionally, certain medications can also induce these symptoms.
Nausea and vomiting,
152
refers to the enlargement of the liver and is commonly associated with hepatitis and other liver diseases.
Hepatomegaly
153
refers to the enlargement of the spleen. Conditions that can cause splenomegaly include mononucleosis, trauma, and illnesses that destroy red blood cells, such as sickle cell anemia and some cancers.
Splenomegaly
154
