Phys Dx: Abdominal Exam

Question 1

When performing ROS for abdominal issues, what other systems should you include?

Answer 1

1 above, 1 below

cardiopulm

GU

GYN

Question 2

a GI patient writhing in pain can indicate…

Answer 2

stone

Question 3

a GI patient who is lying motionless to avoid pain may indicate…

Answer 3

peritonitis

Question 4

protuberant abdomen and umbilicus

bulging flank

areas of tympany and dullness

This may indicate…

Answer 4

ascites, fluid in peritoneal cavity

Question 5

bulging at the umbilicus often when coughing…

this indicates

Answer 5

umbilical hernia

Question 6

most common post-op

bulging near previous incision site

Answer 6

incisional hernia

Question 7

Midline ridge, obvious with neck flexion

separation of rectus abdominus muscles

Answer 7

Diastasis recti

Question 8

an increase of peristaltic waves may indicate…

Answer 8

intestinal obstruction

Question 9

abdominal ecchymosis is indicative of…

Answer 9

intraperitoneal/retroperitoneal hemorrhage

Question 10

vertical striae on the abdomen can indicate…

Answer 10

cushings

Question 11

prominent abdominal veins suggests…

Answer 11

portal hypertension and cirrhosis

Question 12

Splenomegaly

esophageal varices

ascites

hepatic encephalopathy

These are all signs of…

Answer 12

cirrhosis of the liver

Question 13

normal frequency for bowel sounds…

Answer 13

5-34/min

Question 14

normal bowel sound character…

Answer 14

clicks and gurgles

borborygmi (stomach growling)

Question 15

Altered/abnormal bowel sound character

Answer 15

high pitched tinkling

hyper/hypoactive

Question 16

high pitched, tinkling bowel sounds can indicate…

Answer 16

early intestinal obstruction

Question 17

hyperactive bowel sounds can indicate

Answer 17

early peritonitis

diarrhea/gastroenteritis

Question 18

absent bowel sounds are concerning for…

Answer 18

ileus (ilium obstruction)

Question 19

hyperactive bowel sounds progressing to hypoactive is concerning for…

Answer 19

peritonitis

Question 20

4 common areas for bruits in abdominal exam…

Answer 20

aorta

renal arteries

iliac arteries

femoral arteries

Question 21

a distended abdomen that is tympanic to percussion throughout is suggestive of

Answer 21

intestinal obstruction or paralytic ileus

Question 22

protuberant abdomen w/ bulging flanks and dullness is suggestive of…

Answer 22

ascites

Question 23

cirrhosis

hepatitis

alcoholic liver disease

abscess

hepatic tumor/cysts

hereditary condition

biliary disease

heart failure.

These are common causes of…

Answer 23

hepatomegaly

Question 24

when the speen enlarges, where does it expand?

Answer 24

anterior, downward, medial

Question 25

at what volume does dullness appear in the bladder?

Answer 25

400-600mL

Question 26

TTP of the bladder may indicate

Answer 26

cystitis

Question 27

is the bladder usually palpable?

Answer 27

no

Question 28

distension of the bladder, ability to be palpated, indicates

Answer 28

urethral stricture, prostatic hyperplasia, neurogenic bladder

Question 29

light palpation is assessing for

Answer 29

tenderness, guarding, rigidity

Question 30

voluntary contraction of the abdominal wall to with palpation...

Answer 30

guarding

Question 31

involuntary reflex contraction of abdominal wall muscles persistent over several examinations...

Answer 31

rigidity

Question 32

purpose of deep palpation is to...

Answer 32

delineate pain identify masses and organs palpation of liver and spleen in respiratory cycle

Question 33

A physiologic mass to deep abdominal palpation is...

Answer 33

pregnant uterus

Question 34

an inflammatory mass on deep abdominal palpation is...

Answer 34

diverticulitis

Question 35

a vascular mass on deep abdominal palpation is

Answer 35

AAA

Question 36

an obstructive mass on deep abdominal palpation is

Answer 36

distended bladder or dilated loop of bowel

Question 37

RUQ pain radiates to right scapula (+) murphy's sign

Answer 37

acute cholecystitis

Question 38

epigastric pain radiates to back boring pain, drill-like pain

Answer 38

acute pancreatitis

Question 39

pain begins at umbilicus migration to RLQ (+) psoas, obturator, rovsing sign

Answer 39

acute appendicitis

Question 40

LLQ pain

Answer 40

acute diverticulitis

Question 41

(+) costovertebral angle tenderness wraps from mid back to lateral abdomen

Answer 41

acute pylonephritis

Question 42

acute, severe colicky flank pain radiates to groin

Answer 42

nephrolithiasis

Question 43

explosive, excruciating abdominal pain is concerning for...

Answer 43

biliary or renal colic ruptured aneurysm or viscus coronary occlusion

Question 44

abnormal liver presentation

Answer 44

firmness blunt edge surface irregularity

Question 45

congestive diseases (portal HTN, HF, splenic vein thrombosis hematologic malignancies Infx These can cause...

Answer 45

splenomegaly

Question 46

kidney enlargement is suggestive of...

Answer 46

hydronephrosis cysts/tumors polycystic kidney disease

Question 47

an aorta of < _____ is normal

Answer 47

3cm

Question 48

focal dilation of the aorta > 3 cm men over 65 hx of tobacco use this is concerning for...

Answer 48

AAA

Question 49

(+) Rebound tenderness, Guarding, Rigidity may indicate...

Answer 49

peritoneal irritation

Question 50

(+) Rovsing, psoas, obturator may indicate

Answer 50

peritoneal irritation with suspected appendicitis

Question 51

(+) Shifting dullness and fluid wave may indicate...

Answer 51

ascites

Question 52

(+) murphy sign may indicate...

Answer 52

cholecystitis

Question 53

(+) CVA tenderness may indicate

Answer 53

kidney inflammation/pylonephritis