L6 Abdominal Exam Flashcards Preview

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Flashcards in L6 Abdominal Exam Deck (47)
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1

What is the order of examination?

Inspection, auscultation, percussion and palpation

2

What is the main concern when a patient has a hernia?

Incarcerations or strangulations

3

Umbilical hernia

Herniation of abdominal contents through a defective umbilical ring
Spontaneously resolves between 1-2

4

Incisional hernia

Herniation of abdominal contents through a previous incision site

5

Diastasis recti

Laxity of the linea alba that leads to separation of the rectus abdominis muscles and the abdominal contents form a midline ridge

6

When is diastasis recti most obvious?

When the patient flexes the neck by "lifting their head up"

7

Ascites

Accumulation of fluid in the peritoneal cavity, usually secondary to cirrhosis
See bulging flanks

8

Peristalsis

Visible waves of movement seen beneath the skin

9

When do you see peristaltic waves?

Intestinal obstruction (seen in thin people)

10

When do you see increased pulsation?

Abdominal aortic aneurysm

11

What skin markings do you look for?

Color, rashes/lesions, scars, striae, dilated veins

12

When can ecchymosis be seen?

Intraperitoneal or retroperitoneal hemorrhage

13

When are pink-purple striae seen?

Cushings

14

What do prominent veins suggest?

Portal hypertension from cirrhosis

15

Caput medusa

When portal hypertension promotes collateral venous circulation radiating from the umbilicus to the abdominal wall

16

Abnormal auscultation sounds

High-pitched tinkling, hyperactive or hypoactive

17

Normal auscultation sounds

Clicks, gurgles, borboygmi

18

Borborygmi

Prolonged gurgles of hyperperistalsis, "stomach growling"

19

What is associated with high-pitched tinkling bowel sounds?

Intestinal obstruction interrupting the normal flow of contents
The sound is from intestinal fluid and air under tension in a dilated bowel

20

What are reasons for hyperactive bowel sounds?

Diarrhea (gastroenteritis) or early peritonitis

21

What are reasons for hypoactive bowel sounds?

Ileus (little to no bowel activity), peritonitis (may be hyperactive at first but lessens due to progressively severe inflammation and my progress to ileus)

22

What does percussing tympani suggest?

This predominates because of gas in the GI tract

23

What does percussing dullness suggest?

Underlying mass, enlarged organs or scattered areas of fluid/feces

24

Distended abdomen that is tympanic throughout

Intestinal obstruction or paralytic ileus

25

Protuberant abdomen with bulging flanks and dullness

Evaluate for ascites (free fluid sinks to dependent part of abdominal cavity where gas-filled loops of bowel float to the top)

26

Where do you measure the vertical span of the liver?

Midclavicular line (6-12 cm)

27

What happens when the spleen enlarges?

It expands anteriorly, downward and medially

28

When can fullness be percussed in the bladder?

Over 400-600 mL

29

When is the bladder tender?

Cystitis (UTI)

30

When is the bladder distended?

Urethral stricture, prostatic hyperplasia, neurogenic bladder