Cardiac

Question 1

What organs are located in the RUQ?

Answer 1

• Liver - Gallbladder (murphys sign) - arge and small bowel

Question 2

What organs are located in the LUQ?

Answer 2

• Spleen - Stomach -Large and small bowel -pancreas - aorta

Question 3

What organs are located in the RLQ?

Answer 3

• Appendix - Bladder - Right ovary and tube - Large and small bowel

Question 4

What organs are located in the LLQ?

Answer 4

• Sigmoid colon - Left ovary and tube - Large and small bowel

Question 5

what organs are midline?

Answer 5

• renal arteries - umbilicaln region - Hypogastric - aorta - Uterus - Bladder

Question 6

what is the assessment order for the abdomen?

Answer 6

• Inspect - Auscultate - Percuss - Palpate

Question 7

Peritoneum-

Answer 7

lines and protects the abdomen cavity

Question 8

subjective questions about what topics?

Answer 8

Appetite Dysphagia Food intolerance Nausea Vomiting Abdominal pain Bowel habits Past abdominal history Medications Nutritional assessment

Question 9

Appetite

Answer 9

Any change in appetite? Loss of appetite? Change in weight? How much lost or gained? Weight loss intentional or unintentional?

Question 10

Dysphagia

Answer 10

Are they having any difficulty Swallowing ?

Question 11

Food intolerance

Answer 11

Any foods the patient can’t eat? What happens? - Allergic reaction? - Heartburn? - Belching? - Bloating? - Indigestion? Use of antacids? How often?

Question 12

Nausea/Vomiting

Answer 12

Any nausea? Vomiting? How often? How much? Color? Bloody? Coffee grounds? Associated with colicky pain, diarrhea, fever, chills? What foods have been eaten in past 24 hours? Where? Any recent travel? Drink local water or eat fruit? Swimming in public beach/pool?

Question 13

Abdominal Pain

Answer 13

Any abdominal pain? Point to it. In one spot, or moves around? How did it start? How long? Constant or intermittent? Describe pain: cramping, burning, dull, stabbing, aching? Relieved with food or worse after eating? Associated with menses, stress, dietary indiscretion, fatigue, N/V, gas, fever, rectal bleeding,

Question 14

Bowel Habits

Answer 14

How often are BMs? Color? Consistency? Diarrhea? Constipation? Any recent change in bowel movements? Use laxatives? How often?

Question 15

Past Medical History

Answer 15

Ulcers? GB disease? Hepatitis or cirrhosis of liver? Abdominal surgeries? Colorectal or related cancers? Abdominal xray or CT scans?

Question 16

Family History

Answer 16

Colorectal cancer and familial colorectal cancer syndromes Gallbladder disease Kidney disease Malabsorption syndrome

Question 17

when you inspect the abdommen, what are you looking for?

Answer 17

• Contour - scaphoid - flat - obese - protuberant (bulgin - lesions?

Question 18

where should you start auscultating

Answer 18

Right Lower Quadrant

Question 19

what are you auscultaating for ?

Answer 19

Bowel sounds, use the bell of the stethescope and listen for buits in the aorta and renal arteries (Patients with HTN and >50)

Question 21

what are the differences between hyperactive and hypoactive bowl sounds?

Answer 21

Hyperactive

• Loud, high-pitched
• tinckling sound
• diarrhea
• laxative use ans subsiding paralytic ileus
• early mechaanical bowl obstruction gastroenteritis

Hypoactive

• Diminished or absent

sign of decreased mobility following abdominal surgery or with inflammation to the peritoneum

• ​peritonitis
• paralytic ileus following surgery
• Late bowel obstruction

Question 24

Cholecystitis

Answer 24

(Inflammation of the gallbladder)

Signs and Symptoms

Enlarged, tender gallbladder

Check for Murphy’s sign

RUQ pain

Question 25

Appendicitis

Answer 25

(Inflammation of the appendix) **Signs ans Symptoms** Iliopsoas muscle test RLQ pain

Question 26

Ascites

Answer 26

Free fluid in the peritoneal cavity (cirrhosis, right-sided CHF) May have RUQ pain Fluid wave Shifting dullness

Question 27

Enlarged, smooth, non-tender liver (hepatomegaly)

Answer 27

Fatty infiltration Portal obstruction Lymphocytic leukemia May have RUQ pain

Question 28

Enlarged, nodular liver

Answer 28

Late portal cirrhosis Metastatic cancer Tertiary syphilis May have RUQ pain

Question 29

Diastasis Recti (rectus diastasis)

Answer 29

Midline longitudinal ridge resulting form separation of the abdominal rectus muscle Ridge is revealed by raising head when supine

Question 30

Widened aorta

Answer 30

Abdominal aortic aneurysm (\>5cm) (Most located below the renal arteries) Pulsatile mass in upper abdomen (left of midline) Diminished or absent femoral pulses Listen for bruit over the aorta Lower back pain

Question 31

CVA tenderness

Answer 31

Indirect fist percussion over the 12th rib at the costovertebral angle (CVA) Sharp pain occurs with inflammation of the kidney: Kidney stones Kidney infection (pyelonephritis)

Question 32

Hernia

Answer 32

Umbilical Incisional Epigastric Bulging/protrusion Accentuated by an increase in intra-abdominal pressure (crying, coughing, vomiting, straining)

Question 33

Distended bladder

Answer 33

Palpate and percuss in the midline above the suprapubic bone

Question 34

Pyelonephritis/Kidney stones

Answer 34

Infection of the kidney Flank pain, fever, chills, pain radiating down the groin CVA tenderness

Question 35

GI Bleeding

Answer 35

Upper GI (esophagus, stomach) Lower GI (colon polyp or cancer, hemorrhoids Hematemesis, tarry stools (melena) Red blood in stool

Question 36

GI Bleeding

Answer 36

Upper GI (esophagus, stomach) Lower GI (colon polyp or cancer, hemorrhoids Hematemesis, tarry stools (melena) Red blood in stool