Gastrointestinal Flashcards
Ballottement
Technique either single handed or bimanual used to assess a mass in the abdomen.
Practitioners hand is pushed inward at 90 degree angle in the abdomen. If the mass is moveable, it will float and hit the fingertips.
Dullness
Percussion sound that is short, heard over solid organs.
Rosving’s Sign
Palpating the LLQ elicits pain the RLQ
Appendicitis
Caput Medusae
Sign of portal hypertension characterized by distended and engorged superficial veins of the abdomen
Iliopsoas & Obturator Test
Appendicitis
An inflamed appendix can cause irritation to both the iliopsoas and obturator muscules. Movement of these muscule groups by having patient raise the right leg an hold up against resistance of the practitioner (psoas sign), or flex the right leg at the hip and knee and rotate medial and lateral (obturator sign) to illicit pain.
Dance Sign
Absent right lower quadrant bowel sounds, suspicious for intussusception
Murphy’s Sign
Cholecystitis - inflammation of the gallbladder
Patient is asked to take deep breath, as the examiner palpates below the liver margin. If the gallbladder is inflamed and painful, the patient will abruptly stop breathing.
Hyperrsonance
A sound of increased resonance indicating hyperinflation of the lung. Often present in COPD, emphysema, and pneumothorax.
Linea Nigra
Hyperpigmented line on abdomen usually noticed in the second trimester. Runs from the pubic bone to the navel; occasionally extending to the chest. It disappears several weeks after delivery and may be linked to inadequate dietary intake of folic acid.
Markle Sign
Also known as a jar sign for appendicitis
The patient stands on their tiptoes and then allows the heels to hit the floor. A positive sign will cause pain in the abdomen. Used to assess peritoneal irritation, appendicitis.
Tympany
Percussion sound, higher pitched than resonance. Over airfilled viscera.
Charcot’s Triad
Clinical features indicating acute cholecystitis (gallbladder)
characterized by RUQ pain, jaundice, and fever
Liver span
Normal span is 6 to 12 cm.
Can be measured using percussion techniques starting with resonance tones of the lung fields, turning into dullness of the liver.
McBurney Sign
Positive sign may indicate appendicitis
Rebound tenderness over McBurney’s point in the right lower quadrant of the abdomen.
Kehr Sign
Radiating abdominal pain to the left shoulder.
May be concerning for spleen rupture, kidney stone, or etopic pregnancy
Grey Turner Sign
Ecchymosis of the flanks which can ben seen in necrotizing pancreatitis and hemoperitoneum.
Cullen Sign
Bruising around the umbilicus. May indicate necrotizing pancreatitis.
CVA percussion
Direct or indirect percussion of the costovertebral angle for kidney tenderness
Troiser’s Sign
Sign of metastatic abdominal malignancy, characterized by hard, enlarged left supraclavicular lymph node (Virchow’s node)
Blumberg Sign
Assessment of rebound tenderness in the abdomen to assess for appedicitis or peritoneal inflammation
