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AHA Final > Module 9- GI Assessment > Flashcards

Module 9- GI Assessment Flashcards

1
Q

Function of the abdomen

A
  • Digestion
  • Absorption of food
  • Storage
  • Abdominal muscles assist in respiratory
  • Protect inner organs
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2
Q

Structures of the abdomen

A
  • Stomach
  • Liver
  • Kidneys
  • Spleen
  • Pancreas
  • Gallbladder
  • Small intestine
  • Large intestine
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3
Q

Function of the anus

A
  • Excretes stool by two anal sphincters (internal and external)
  • Contains rectal contents
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4
Q

Structure of the anus

A
  • Connected to the Sigmoid colon
  • Rectum
  • Stool pass through valves of Houston
  • Rectal Ampulla (stores) before elimination
  • Anal canal (column, valve and crypt)
  • Anorectal junction
  • Internal sphincter
  • External sphincter
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5
Q

Function of the rectum

A
  • Stool stops here before elimination through the anus
  • Electrolyte absorption (Na, K, Cl)
  • In-digestive food are broken down by bacteria
  • Water and mucus thickens stool
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6
Q

Structure of rectum

A
  • Continuation of sigmoid colon
  • Contains the Valves of Houston before the Peritoneum (connection to the anus)
  • Stops at Rectal ampulla (stored feces)
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7
Q

Health history Questions for Abdomen

A

1) Change in Appetite
2) Dysphagia
3) Abdominal pain
4) Nausea/Vomiting
5) Bowel habits
6) Past Abdominal history
7) Medications
8) Food intolerance
9) Alcohol and Tobacco
10) Nutritional Assessment

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8
Q

Organs in the RLQ

A
  • Appendix
  • Cecum
  • Right ovary/Fallopian tube
  • Right ureter
  • Right spermatic cord
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9
Q

Organs in the RUQ

A
  • Liver
  • Gallbladder
  • Duodenum
  • Head of pancreas
  • Right kidney/adrenal
  • Hepatic flexure of colon
  • Part of ascending and transverse colon
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10
Q

Organs in the LUQ

A
  • Stomach
  • Spleen
  • Left lobe of liver
  • Body of pancreas
  • Left kidney/adrenal
  • Splenic flexure of colon
  • Part of transverse and descending colon
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11
Q

Organs in the LLQ

A
  • Part of descending colon
  • Sigmoid colon
  • Left ovary and Fallopian tube
  • Left ureter
  • Left spermatic cord
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12
Q

Why is auscultation done before palpation of the abdomen?

A
  • Palpation’s can increase peristalsis which can give a false interpretation of bowel sounds
  • Can identify bruits and if bruits are identified do not palpate! Could indicate an aortic aneurysm
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13
Q

7 Steps to Inspection of Abdomen

A

1) Contour
2) Symmetry
3) Umbilicus
4) Skin
5) Pulsation/Movement
6) Hair distribution
7) Facial expression

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14
Q

Inspection- Contour

A
  • Done at eye level

- Describe contour as flat, rounded, scaphoid and protuberant

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15
Q

Inspection - Symmetry

A
  • Should be symmetrical bilaterally
  • Look for bulges/masses/hernia
  • Client to take a breath and highlight change
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16
Q

Inspection - Umbilicus

A
  • Inverted/Everted
  • Normally umbilicus is mid-line and inverted
  • Assess for inflammation, discoloration, bleeding and hernias
17
Q

Inspection - Skin

A
  • Surface should be smooth and even tone

- Assess for inflammation, jaundice, stretch marks (striae), Cushing’s Syndrome, adhesion’s and scar tissue

18
Q

Inspection - Pulsation/Movement

A
  • Muscle relaxation
  • Peristalsis and rippling movement can be identified
  • Assess for distention
  • Abdominal obstruction can be identified with peristalsis and abdominal distension
19
Q

Inspections - Hair distribution

A
  • Assess normal hair growth

- Abnormal hair growth can indicate blood flow issues/Hirutisim/endocrine issues

20
Q

Inspections - Facial Expressions

A
  • Should be comfortable and relaxed
  • Look for any signs of distress
  • Distress can be sign of obstructed bowels, discomfort and peritonitis/infections
21
Q

Auscultation assessment - Normal Bowel Sounds

A
  • Diaphragm of stethoscope listen to all 4 quadrants
  • Start RLQ at the ileocecal valve
  • Note character/Frequency
    Normal sounds: High-pitched gurgling
  • Stomach growling (borborygmus)
22
Q

Auscultation assessment - Abnormal findings

A
  • Hyperactive sounds (loud/rushing) - Bowel obstruction

- Absent sounds (inflammation)

23
Q

Auscultation assessment - Vascular Sounds

A
  • Bell of stethoscope
  • Assessing aorta, renal, iliac and femoral arteries
  • Absent sound normal
  • Assess for bruits
24
Q

Palpation Assessment - Light Palpation technique

A
  • Keep hand low to abdomen
  • Use of four fingers depressing skin 1 cm
  • Rotation motion and lifting fingers to next section
  • Checking skin surface, temperature, swelling, rigidness, moisture, pulsations, tenderness, pain and superficial muscles
25
Q

Normal findings of Abdomen assessment

A
  • Smooth even skin tone
  • Flat contour
  • Equal bilateral symmetry
  • Inverted umbilicus
  • Consistent hair growth
  • High pitched gurgling sounds
  • Stomach growling
  • No discomfort when palpating
  • Absent sounds when assessing vascular arteries
26
Q

Abnormal Findings - Abdominal Distention

A
  • Obesity (rounded contour)
  • Air/Gas
  • Ascites (bulging sides in supine)
  • Ovarian cyst
  • Pregnancy
  • Feces (localized distention)
  • Tumour
  • Bulges/Masses
27
Q

Factors of Intestinal Obstruction

A
  • History of previous abdominal surgery
  • Vomiting
  • Absence of stool/gas
  • Distended abdomen
  • X-ray findings of obstruction
  • Hyperactive bowel sounds
  • Dehydration/fluid loss
  • Accumulation of fluid
  • Colic pain
  • Fever
  • Pressure from excess fluid
  • Hypovolemic shock (Low BP, High HR)
28
Q

Abnormalities on Inspection - Hernia’s

A
  • Umbilical Hernia - incomplete closure
  • Epigastric hernia - fatty nodule at midline (palpate when standing)
  • Incision Hernia
  • Diastasis Recti (partial/complete separation of the abdominal recti’s - six pack)
29
Q

Abnormal Bowl Sounds

A
  • Succussion Splash- Loud splash when infant is rocked side to side - increased air/fluid in stomach
  • Hypo-active bowel sounds (Diminished/absence) - indicates inflammation/late bowel obstruction
  • Hyperactive bowel sounds (Loud/gurgling) - indicates early bowel obstruction
  • Bruits
30
Q

Abnormal Abdominal Friction rub and Vascular sounds

A
  • Peritoneal Friction rub (Liver/Spleen)- rough/grating sounds - indications peritoneal inflammation or tumour
  • Vascular Sounds (Arterial/Venous hums/murmurs)
  • 3 conditions:
    1) Abdominal Aortic Aneurysm
    2) Renal artery stenosis
    3) Partial occlusion of femoral arteries (heard in inguinal region)
31
Q

Abnormalities detected on Palpation

A
  • Enlarged liver - cirrhosis/acute hepatitis
  • Enlarged nodular liver - cancer
  • Enlarged gallbladder - gallstones
  • Enlarged spleen - infections
  • Enlarged kidney - cysts/cancer
  • Aortic aneurysm - high risk for rupture/life threatening
32
Q

Referred pain common sites

A
  • Liver, RUQ/ epigastrium - Nausea
  • Esophagus: midepigastrium/lower sternum- GERD
  • Gallbladder: right/left scapula
  • Pancreas: midepigastric, radiating to back
  • Duodenum: does not radiate
  • Stomach: epigastric, radiates to back/substernal
  • Appendix: periumbilical, shifts to RUQ
  • Kidney: flak or lower abdominal
  • Small intestine: diffuse abdominal
  • Colon: Lower abdomen
33
Q

7 Health History Questions for Anus/Rectum

A

1) Usual bowl routine
2) Change in bowel habits
3) Rectal bleeding/blood in stool
4) Medications
5) Rectal Conditions
6) Family history
7) Self-care behaviour

34
Q

Abnormalities of Anal regions

A
  • Pilonidal cyst or sinus - contains hair
  • Anorectal fistula - inflamed gastro-intestinal tract and creates an abnormal passed from anus to skin
  • Fissure - tear occurred from trauma
  • Hemorrhoids - varicose veins- results from pressure/strain
  • Rectal prolapse - rectal membrane protrudes from anus - weakened
  • Pruritus Ani (Itching/burning)- infection
35
Q

Abnormalities of Rectum

A
  • Abscess - infections
  • Rectal polyp - common nodule
  • Fecal impaction (Colon block) - Constipation
  • Carcinoma - Rectal cancer

AHA Final (6 decks)

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