MyBelly Flashcards
(49 cards)
What are the five things to evaluate with an enlarged abdomen?
Fat- adipose tissue accumulated on abdominal wall- doesn?t percuss to tympany, Fetus- pregnancy- positive fetal heart tones after 10 weeks gestation, Flatus- is the patient flatulent, abdomen distended with gas in large intestine- hyper-tympanic, Fluid-shifts from tympanic to dull, location changes with patient position change, may do fluid wave test to check for excessive abdominal fluid, Fibroid- solid mass in abdomen may be malignant or benign, percusses as dull
Which should you do first auscultation, percussion or palpation?
Auscultation because you don’t want to alter the frequency of sounds.
Where do you check for for bruits?
over the the aorta, iliac, femoral arteries
What sounds should you hear over most of the abdomen?
Tympany
Where is the only place you should hear dullness in the abdomen when percussing?
Liver
What is the normal size of the liver?
Midclavicular line- 6-12 cm, midsternal line- 4-8cm
What are some things to remember when palating the abdomen?
Always warm your hands first, Light palpation- gentle probing with hands, relaxes patient, use flat pads of fingers, NOT finger tips, Identify superficial masses, Assess for voluntary guarding- flinching, Ask patient to breathe in and out with mouth open
What is the depth of palpation for the abdoment?
Deep- 2-3 light 1-2
Should the bladder, spleen and kidneys be palpable?
No :)
How should you palpate the liver?
Palpate liver last- use non-dominant hand to support patient?s back at 11th-12th rib, dominant hand presses abdomen inferior to border of liver, Ask patient to take a deep breath, palpate for inferior border of liver as it bumps your examining fingers at the MCL, Normally, liver should be 3cm below right costal margin at MCL, Note any pain or tenderness with liver palpation
In an acute abdominal pain situation when would you assess?
guarding, rebound tenderness, psoas sign, obturator sign
How do you chack for rebound tenderness?
Pain worsens when deep palpation removed? Does it hurt more when I press down or when I let go?
What is the Psoas sign?
Psoas sign- patient flexes thigh against examiner?s hand, pain indicates + Psoas sign
What is the obturator sign?
Obturator sign- flex thigh and rotate hip toward the midline, + pain = positive sign
If there is a positive psoas and/or obturator sign, what could this indicate?
These abnormalities indicate an irritated peritoneum from inflammation or infection
If someone comes into the ER with Cullen’s sign, would this require immediate attention?
YES!! Blood has acumulated in the abdomen could Indicate acute hemorrhage, Possibly ruptured ectopic pregnancy, Ruptured ulcer of duodenum
If there is CVA (costovertebral angle) tenderness, what could this indicate?
Kidney infection; esp important to assess in pregnant women –> could lead to pre-term labor/birth
what are the important landmarks of the abdomen
costal margin and inguinal ligament
what are the two methods of assessment for the abdomen
four quadrants or nine section
what are the 4 quadrants of the abdomen
RUQ, RLQ, LUP, LLQ
what are the nine sections
epigastric, umbilical, hypogastric/suprapubic, and flanks of each side
what internal contents are in RUQ
liver, right kidney, pancreas, gall bladder, ascending/transverse colon
what internal contents are in RLQ
appendix, ascending/transverse colon, sm. Intestine, ureter, major vein/artery to rt leg, ilian artery
what internal contents are in LUQ
stomach, lt. kidney, spleen, colon, pancreas
