Phys Dx- Abdominal Exam

Question 1

Striae

Answer 1

large purple colored stretch marks
Common with Cushings
Large normal colored stretch makrs - pregnancy, weight gain, rapid growth

Question 2

Linea Nigra

Answer 2

dark line of hyperpigmentation with pregnancy

Question 3

Normal venous patterns

and shunts from obstructions

Answer 3

Upward from umbilicus
Downward from umbilicus
Superior vena cava obstruction causes shunt downward
Inferior vena cava or hepatic portal vein obstruction cause shunt upward - caput medusa radiating flow w/ ascites

Question 4

Diastasis recti

Answer 4

split rectus admomonis muscles

obvious with neck flexion

Question 5

Types of Abdominal Bulges and Causes

Answer 5

Generalized - obesity
Suprapubic - full bladder, tumor mass, pregnancy
Bulging flanks - ascites

Question 6

ascites definition

Answer 6

free peritoneal fluid

Question 7

when would you see increased peristalsis

Answer 7

GI obstuction or gastroenteritis

Question 8

when would you see abd. puslations

Answer 8

AAA

Question 9

Surgical incision over appendix

Answer 9

McBurney’s

Question 10

Surgical incision over suprapubic

Answer 10

Pfannestiel

Question 11

Surgical incision that’s muscle splitting

Answer 11

Gridiron

Question 12

Hyperactive Bowel Sounds

Answer 12

1. Peritonitis
2. Early obstruction
3. gastroenteritis
4. borborygmi - loud active sounds

Question 13

High-pitched Tinkling Bowel Sounds

Answer 13

1. Obstruction

2. fluid under pressure rushing through intestines

Question 14

Paralytic ileaus

Answer 14

little or no bowel activity - hypoactive bowel sounds!

Question 15

Hypoactive bowel sound cause

Answer 15

late peritonitis - inflammation progresses to ileus

Question 16

Causes of Hepatomegaly

Answer 16

1. CHF
2. cirrhosis
3. hepatitis
4. tumor
5. abscess
6. cysts

Question 17

What does shifting dullness test?

Answer 17

ascites: free fluid goes to the dependent areas of the abd and air rises to the top

Question 18

what does fluid wave test for?

Answer 18

ascites: tells us whether distention is due to fluid

pt applies pressure at midline of abd. and tap on one flank and feel for fluid wave on opposite flank

Question 19

Succusion spalsh

Answer 19

shake the abd with hands and listen for splash sound - bowel obstruciotn gastic outlet bsturction, intestinal perforation or ascites

Question 20

Removing fluid from peritoneum

Answer 20

paracentesis - over 4 areas of abd

Question 21

Splenomegaly

Answer 21

mononucleosis
viral, bacterial, or parasitic infection
hematologic disorder - leukemia, hemolysis
cirrhosis
cycts

Question 22

Superficial Abd reflexes

Answer 22

upper abd: t7-9
lower abd T11-T12
creamasteric T12, L1-2

Question 23

Palpation of aorta - abdnormal

Answer 23

Use the 2 hand technique for pulsations and size,

greater than 3 cm is AAA

Question 24

LLQ pain

Answer 24

diverticulitis

Question 25

Causes of Explosive Excrutiating Abd Pain

Answer 25

``` biliary colic coronary occlusions ruptured bowel AAA ruptured viscous - peptic ulcer renal colic - ureteral calculus ```