Ch. 22 (Abdomen) Flashcards
(66 cards)
1
Q
What region classifies all the internal organs?
A
viscera
2
Q
What kind of organs change shape depending on whatever is in it?
A
hollow organs
3
Q
What organ is located behind the stomach?
A
pancreas
4
Q
what organ is located in the posterior wall of the abdominal cavity underneath the stomach?
A
spleen
5
Q
What is known as the angle between the spine and ribs, where the kidneys are?
A
costovertebral angle
6
Q
What are the famous hollow organs?
A
- stomach
- gallbladder
- small intestine
- bladder
- colon
- aorta
7
Q
What happens to the abdomenal organs with aging?
A
- increased fat disposits
- galbladder: sluggish, drainage slows down
- liver: shrinks
- bowels: constipation - movements slow down
8
Q
What is located in the right upper quadrant?
A
- liver
- gallbladder
- head of pancreas
- stomach
- right kidney/adrenal
- colon (hepatic flexure)
- duodenum
9
Q
What is located in the right lower quadrant?
A
- colon (ascending)
- cecum
- appendix
- right ovary/tube OR right spermatic cord
- right ureter
10
Q
What is located in the left upper quadrant?
A
- stomach
- spleen
- left lobe liver
- body of pancreas
- left kidney/adrenal
- colon (splenic flexure, parts of transverse, descending)
11
Q
What is located in the left lower quadrant?
A
- colon (descending, sigmoid)
- rectum
- left ovary/tube OR left spermatic cord
- left ureter
12
Q
When performing an abdomen exam, how should the pt be positioned?
A
- on their back
- hands at side
- head on pillow
13
Q
Where should you be positioned during an abdomen exam?
A
pts right side
14
Q
When looking at the side profile of the abdomen, what different kinds of profiles could they have?
A
- flat (flat)
- scaphoid (deep depression)
- rounded (round)
- protuberant (pregnant, bulging)
15
Q
What are the seven f’s that cause protuberance in the abdomen?
A
- fat
- fetus
- flatuence
- fluid
- fibroid tumor
- feces
- fatal growth
16
Q
Abdomen breaks the order of what you should be performing second during the physical exam. What do you do first in the physical exam for the abdomen?
A
auscultation
17
Q
Abdomen breaks the order of what you should be performing second during the physical exam. Why do we auscultate before palpating and percussing?
A
alters baseline sounds
18
Q
Where do we start during auscultation of the abdomen?
A
- right lower quadrant
19
Q
What do bowel sounds like?
A
- bubbling
- gurgling
20
Q
What do hyperactive bowel sound like?
A
- loud
- gurgling
- going crazy
21
Q
What usually causes hyperactive bowel sounds?
A
- diarrhea
- stomach bug
22
Q
What do hypoactive bowel sound like?
A
- diminished
- related to decreased mobility
- small
23
Q
What usually causes hypoactive bowel sounds?
A
- after surgery
- bowel obstruction
- inflammation in the perioteal cavity
- constipation
24
Q
If bowel sounds are absent, then how long can you clarify that they are absent when auscultating?
A
5 minutes
25
What vascular locations do you listen to during the abdomen physical auscultation exam?
* aorta
* left renal artery
* iliac artery
* femoral artery
26
What are we listening for in the abdomen arteries during the physical auscultation exam?
* bruit - opening is blocked
27
During the abdomen physical exam, what is percussion used for?
* done to locate organs
* screen for abnormal fluids and masses
28
During the abdomen physical exam, what is the normal percussion sound heard?
tympany
29
How hard do we percuss during an abdomen physical exam?
light percussion - percuss lightly in all four quadrants
30
Why do we perform costoverbral angle tenderness (CVAT)?
* check for kidney infection
31
How do you perform a costoverbral angle tenderness (CVAT) test?
* left hand on the posterior abdomen cavity where kidneys would be
* banging right hand on back of left hand over kidneys
32
Why do we palpate the abdomen?
* judges size, location and consistency of certain organs
* screen for abdominal masses and/or tenderness
33
How do you palpate the abdomen during light palpation?
* four fingers together, in gentle circular motion
* 1cm deep
34
What kind of palpation do we perform first during the abdomen physical exam?
light before deep
35
How do you palpate the abdomen during deep palpation?
* 5cm
* same technique just deeper
36
What should you note when feeling a mass in the abdomen?
* location
* size
* hard or soft
* tenderness
37
How do you palpate the liver in a physical exam when assessing the abdomen?
* left hand under back
* right hand on RUQ, fingers parallel to midline
* push down deeply upon inhalation
| nml to feel edge of liver bump your fingers during inhalation
38
Is the spleen normally palpable? Should you palpate it repeatedly if it is palpable?
1. no - palpable = enlarged
2. no - risk for rupture
39
How do you palpate the spleen in a physical exam when assessing the abdomen?
* reaches left hand over abdomen, behind left side
* right hand obliquely on LUQ w/fingers pointing toward left axilla & inferior to rib margin
* push down and ask pt to take deep breath
40
What do you do when performing rebound?
press down firmly and quickly let go
| typically for appendicitis, inflammation in belly
41
What are you looking for when performing rebound on the abdomen?
rebound tenderness - pain upon immediate letting go (not when you press down)
| testing appendix
42
What do you do when performing the iliopsoas test on the abdomen?
* pt lies on back, lifts right leg straight up
* put pressure on thigh and ask pt to keep leg up
if pain occurs - likely from inflammation
| testing appendix
43
What do you do when performing the obturator test on the abdomen?
* pt lies on back
* rotate left hip with leg
record for pain
| testing appendix
44
What describes the Murphy sign or inspiratory arrest?
pt cannot take a full deep breath when palpating RUQ
| test for inflamed galbladder or liver
45
What abdomen abnormality causes the digestive enzymes are attacking the pancreas causing inflammation?
pancreatitis
46
What abdomen abnormality causes pain in the abdomen that spreads to the back, severe nausea, vomiting, and the pain worsens when eating, drinking or laying flat?
pancreatitis
47
How do we treatment pancreatitis?
* rest
* IV fluids
* pain medication
* encourage cessation of alcohol
| not much we can do
48
What abdomen abnormality causes heartburn, dysphagia, nausea and burning and can be aggrevated by pregnancy?
GERD
49
What abdomen abnormality causes stomach acid to backflow into the esophagus?
GERD
50
How do we treat GERD?
* elevate your head in bed
* stop smoking
* don't lie down after a meal
* avoid alcohol, choocoalte, caffeine, fatty foods and peppermint
51
What abdomen abnormality causes inflammation of the galbladder from a blocked duct?
Cholecystitis
52
What abdomen abnormality causes abdomen pain that spreads into the shoulder or upper right abdomen, bloating, nausea and vomiting?
Cholecystitis
53
How do we treat cholecystitis?
* positive murphy sign
* avoid fatty foods & alcohol
| usually **galbladder is removed**
54
What abdomen abnormality causes a bacterial infection with inflammation in the kidneys?
Pyelonephritis
55
What abdomen abnormality causes aching back or suprapubic pain, dysuria and a fever?
pyelonephritis
56
What do we treat pyelonephritis?
* assess for CVAT
* increase fluids
* antibotics
* rest
57
What abdomen abnormality is caused by a virus obtained by fecal contamination in foods?
Hepatitis A
58
What abdomen abnormality causes jaundice, RUQ pain, lose of appetitie, vomiting, fever and diarrhea?
hepatitis A
59
How do we treat hepatitis A?
* blood test - enzyme, bilirubin, antibodies check
* rest
* perform hand hygiene
| goes away on its own
60
What abdomen abnormality causes a gap in the muscular wall that allows contents in the abdomen to protrude outwards?
Hernia
61
What abdomen abnormality causes bulging in either side of the pubic bone that is more noticeable when sitting upright or coughing, burning or aching sensation at bulge and discomfort?
hernia
| usually overweight males that lift heavy objects
62
How do we treat a hernia?
* cold compress
* medication
* light stretch & movement
| usually resolved with surgery
63
What abdomen abnormality causes the appendix to become swollen and inflamed from a build up of bacteria?
Appendicitis
64
What abdomen abnormality causes diarrhea or constipation which can decrease the pain, RLQ pain, nausea, and an internal pressure such as a cough that can make the pain worse?
appendicitis
65
What tests will prompt pain in someone with appendicitis?
* rebound
* obturator
* iliopsoas
66
How do we treat appendicitis?
* blood test for WBC count
* pain relievers
* surgery
