What is the sequence of skills you should perform when assessing the abdomen?
Inspection, Ausculatiation, percussion, palpation.
What is a fan shaped fold of the peritoneum that covers most of the small intestine and anchors it to the posterior abdominal wall?
Mesentery
What is the alimentary tract? (Length)
Tube from mouth to anus (27 feet)
How long is the esophagus ?
10 inches
How long is the small intestine?
21 feet
How long is the large intestine?
4.5 to 5 ft long
What connects the pharynx to the stomach?
Esophagus
Where does the esophagus enter the stomach?
Cardiac orifice
What are the parts of the small intestines and their sizes?
Duodenum 12 in, jejunum 8 feet, ilium 12 feet..
Liver is on what side?
Upper right
What side is the spleen on?
Upper left (below kidney)
When does the pancreatic buds, liver and gallbladder begin to from in gestation?
4th week
What is an end product of fetal metabolism and is produced at about 17weeks?
Meconium
When is the gastrointestinal tract capable of adapting to extrauterine life?
By 36-38 weeks gestation
When is the spleen active in formation of blood ?
Till First year
When is the kidney able to produce urine in gestation ?
12 weeks
What are the 9 regions the abdomen can be broken down into?
Epigastric, umbilical, hypogastric, R and L hypochondriac, r and L lumbar, and R and L Inguinal
Marked pulsation in the abdomen many occur as a result of what?
Abdominal aortic aneurysm
When auscultating the abdomen you should hear clicks and gurgles that occur in what range per min?
5-35
What are loud prolonged gurgles called?
Borborygmi (stomach growling)
When auscultating the abdomen what sounds would cause you to think there is an emergency ?
No sounds after 5 min
High pitched tinkling sounds suggests what in the abdomen ?
Intestinal fluid and air under pressure (early obstruction)
Decreased bowl sounds occur in what?
Peritonitis and paralytic ileus
What till have greater tympani the small or large intestines?
Small
What part of the colon have more Dullness ?
Descending and sigmoid
What is meganblase?
Gastric air bubbles
Where should you hear a deeper tympani when doing percussion ?
Left anterior rib change and the epigastric region
If the liver percusses more than 1 inch below the costal Marin what should you consider?
Hepatomegaly or downward displacement of the liver due to depressed diaphragm
A superior liver boarder below 5th-7th intercostal space is indicative of what?
Liver atrophy, lung disease pushing the liver downwards
A superior liver boarder above the 5th-7th intercostal space may indicate what?
Abdominal mass or hepatomegaly
What is the actual size of the liver?
6-12 cm
What may obscure the superior liver boarder during percussion?
Plural effusion or lung consolidation
What may obscure the inferior liver boarder during liver percussion?
Gas in the ascending and transverse colons
Where should dullness be heard when percussing the spleen?
5th-10th intercostal spaces
What can give a false positive for the spleen size during percussion?
A full stomach or intestines
What is the depth for light palpation?
1 cm
What is the dearth for moderate palpation ?
2-3 cm
What is the depth of palpation for deep?
4 cm
What does light palpation help us identify ?
Muscle guarding and inflammation
A large mass or distended structure may first be identified as an area of?
Resistance
What may cause a false positive when doing deep palpation?
Over the cecum, sigmoid, aorta, xiphoid process (or other bony prominences)
Softness at the center of the umbilicus could indicate what?
Hernia
If there is to much fat or muscle on the persons abdomen what can you do?
Use the biannual technique
A tender gallbladder indicates what?
Cholecystitis
A nontender but palpable gallbladder Indicates what?
Obstruction of the duct or cholilthiasis
What kidney tends to be More palpable?
The right