Chapter 11: The Abdomen Flashcards Preview

Bates' Guide to Physical Examination and History Taking > Chapter 11: The Abdomen > Flashcards

Flashcards in Chapter 11: The Abdomen Deck (17)
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Dilated veins visible upon inspection of the abdomen may be indicative of...

...hepatic cirrhosis or inferior vena cava obstruction.
p. 453


Pink-purple striae may indicate...

...Cushing's syndrome.
p. 453


What percentage of healthy individuals have abdominal bruits?

4 to 20%
p. 454


When is a bruit concerning?

When is has both systolic and diastolic components
p. 454


In what conditions might you hear a friction rub in the liver or spleen?

hepatoma, gonococcal infection around the liver, splenic infarction, and pancreatic carcinoma
p. 455


Involuntary ridigity of the abdomen suggests...

...peritoneal inflammation.
p. 455


What is a positive splenic percussion sign?

A change in percussion note from tympany to dullness on inspiration.


What is a positive Rovsing's sign?

Pain in the RLQ during LEFT-sided palpation and release. (indicative of appendicitis)
p. 468


How do you test for a psoas sign?

Place your hand just above the patient's right knee and ask the patient to raise that thigh against your hand. Alternatively, ask the patient to turn onto the left side. Then extend the patient's right leg at the hip. Flexion of the leg at the hip makes the psoas muscle contract.
Increased abdominal pain with either maneuver constitutes a positive psoas sign.
p. 468


What is the significance of a positive psoas sign?

Increased abdominal pain on either maneuver suggests irritation of the psoas muscle by an inflamed appendix.
p. 468


How do you test for an obturator sign?

Flex the patient's right thigh at the hip, with the knee bent, and rotate the leg internally at the hip. This maneuver stretches the internal obturator muscle.
Right hypogastric pain constitutes a positive obturator sign.
p. 468


What is the significance of a positive obturator sign?

It suggests irritation of the obturator muscle by an inflamed appendix.
p. 468


How do you check for Murphy's sign?

Hook your left thumb or the fingers of your right hand under the costal margin at the point where the lateral border of the rectus muscle intersects with the costal margin. Ask the patient to take a deep breath. Watch the patient's breathing and note the degree of tenderness. A sharp increase in tenderness with a sudden stop in inspiratory effort constitutes a positive Murphy's sign.
p. 468


What is the significance of a positive Murphy's sign?

It indicates acute cholecystitis.
p. 468


What is a ventral hernia?

A hernia in the abdominal wall exclusive of groin hernias.
p. 468


The cause of intestinal obstruction or peritonitis may be missed by overlooking a...

...strangulated femoral hernia.
p. 468


When trying to differentiate between a mass in the abdominal wall vs a mass in the abdominal cavity, it is important to remember...

...a mass in the abdominal wall remains palpable when the patient flexes the abdominal muscles, but an intra-abdominal mass is obscured by muscular contraction.
p. 469