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Clinical Med > Test 4 > Flashcards

Test 4 Flashcards

(69 cards)

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1
Q

Abd exam basic structure:

A

look
listen
feel - percuss then palpate

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2
Q

Three patterns of pain

A

1) visceral-solid organ when capsule stretches;hollow organs;difficult to localize;varies in quality (gnawing, burning, cramping..);associated sympt(sweating, pallor, nausea…);
2) pariertal-inflam in parietal peritoneum; steady or achy; more severe than visceral; worse with movement
3) referred-develops as initial pain worsens; superficial or deep; usually localized; may be from a completely dif area

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3
Q

R UPPER QUAD

A 
liver and gallbladder
pylorus
duodenum
head of pancreas
right adrenal gland
part of R kidney
hepatic flexure of colon
portions of ascending and transverse colon
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4
Q

L UPPER QUAD

A 
left lobe liver
spleen
stomach
body pancrea
left adrenal
part of L kidney
splenic flexure
part of transverse and descending colon
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5
Q

R LOWER QUAD

A 
lower pole of right kidney
cecum and appendix
bladder (if distended)
ovary and salpinx
uterus (if enlarged)
R spermatic cord
right ureter
portion of acending colon
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6
Q

L LOWER QUAD

A 
lower pole left kidney
sigmoid colon
bladder (if distended)
ovary and salpinx
uterus (if enlarged)
left spermatic cord
L ureter
portion  of descending colon
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7
Q

Grey-Turners sign

A

bruising of the flanks (ecchymosis)
causes: pancreatitis, abd trauma, ruptured AAA, ruptured ectopic prego, hemoperitoneum)

LOW SPECIFICITY AND DISAPPOINTING SENSITIVITY

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8
Q

Cullens sign

A

Periumbilical ecchymosis
causes: Panceatitis, ruptured ectopic prego

LOW SPECIFICITY AND DISAPPOINTING SENSITIVITY

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9
Q

test name for peritonitis:

A

heel jar or markle

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10
Q

linea negra

A

line of pigmentation that often dev during pregnancy

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11
Q

caput medusa

A

dialated tortuous supervicial veins radiating upward from the umbilicus

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12
Q

diastasis recti

A

separation between the left and right side of the rectus abdominus muscle

prominent when patient raises head

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13
Q

scaphoid

A

sunken in abdomen - malnutrition

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14
Q

distended lower half

A

buldge kind of umbilicus down-ish - bladder distention, pregnancy, ovarian mass, sigmoid tumor

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15
Q

protuberant abdomen

A

whole abdomen pretty big - excess gass, ascites, organ enlargement, obesity

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16
Q

long prolonged gurgles abdomen

A

borborygmi:normal sounds
rate of 5-35 per min
stomach growl gr

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17
Q

increased sounds abdomen

A

gastroenteritis

early obstruction or hunger

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18
Q

high pitched tinkling abdomen

A

intestinal fluid and air under pressure

early obstruction

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19
Q

decreased sounds abdomen

A

peritonitis and paralytic ileus

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20
Q

absent sounds abdomen

A

must listen for a full five minutes
associated with pain and rigidity
==surgical emergency

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21
Q

normal percussion sound usually is

A

tympanic (gas filled) or dull (fluid filledbowel)

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22
Q

what suggests intestinal obstruction?

A

protuberant abdomen that is diffusely tympanitic

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23
Q

tympany

A

muscial note of higher pitch than resonance

located over air filled viscera

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24
Q

hyperresonance

A

between tympany and resonance

located at base of lung

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25
resonance
sustained note of moderate pitch | located over lung tissue and sometimes abdomen
26
dullness
shot, high pitched note with little ressonance | located over solid organs adjacent to air-filled structures
27
what is the test for ascites:
fluid wave test... assistant hand on mid line and you puhs/nudge one side toward midline swiftly... if "wave" is felt to other side of assistnat's hand then there is ascites
28
shiftin dullness test
another test for ascites -- laying down and standing up ... dullness and tympanic sound line will move if ascites
29
lloyd's punch test
costovertebral angle tenderness (kidneys) | first palpate and askif pain.. indirect thump then ... ifkidney infection or whatever itll be painful
30
tenderness is...
discomfort elicited by palpation
31
guarding is
VOLUNTARY contraction of the abd musculature due to tenderness, fear, the examiners cold hands or patient's anxiety
32
rebound is...
abd tenderness that is WORSE when palpating fingers are quickly removed from the place of palpable tenderness
33
peritonitis is...
inflamation of the peritoneum made worse by patient movement, abd wall percussion, and with palpation
34
burning pain in adbomen
peptic ulcer
35
cramping pain in abd
biliary colic, gastroenteritis
36
colicky pain in abd
appendicitis with impacted feces, renal stone
37
aching pain in abd
appendiceal irritation
38
knifelike pain in abd
pancreatitis
39
ripping or tearing pain in abd
aortic dissction
40
gradual pain in abd
infection
41
sudden pain in abd
duodenal ulcer, acute pancreatitis, obstruction, or perforation
42
common pancreatitis stuff
-sudden LUQ epigastric or umbilical pain -may refer to L shoulder -associated: vomitting, fever, shock -PE: epigastric tenderness; + Grey turner; + Cullen -most common causes: gallstones and excessive alcohol -less commonly: hypertriglycidemia
43
common cholecytitis stuff
- severe, unrelenting RUQ or epigastric pain - refers to right subscapular area - associated: anorexia, vomiting, fever, jaundice - PE:RUQ tender; +Murphy
44
common diverticulitis stuff
- LLQ pain or localized to diseased area - associated: fever, anorexia, dhiarrea - PE:LLQ pain on palpation; borborygmus - common of large intestine - formation of pouches (diverticula) on the outside of colon and inflamation of the diverticula
45
common pelvic inflamatory disease stuff
- Lower quad in sexually active female - associated: nausea, vomiting, cervical dischange, dyspareunia - PE: adnexal and cervical tenderness - basically infection of uterus, fallopian tubes and ovaries - can form scar formation
46
common appendicitis stuff:
- intitially present with periumbilical or epigastric pain that localized to RLQ - colicky - associated: fever, nausea, vomiting, anorexia - PE: guarding; +obturator, iliopsoas, rovsing, markle, Mcburney signs - inflmation of appendix
47
colon risk factors:
- 50+ years - family history - personal history: polyps, crohns or ulcer diease, FAP, HNPCC, ovarian or endometrial cancer - ethnic: Jewish - low fiber and high fat - low fruit and veg intake - obesity - smoking - lack of reg exercise - alchol in high q
48
blumberg
rebound tenderness (peritoneal irritation, appendicitis)
49
cullen
ecchymosis around umbilicus (hemoperitoneum, pancreatitis or ectopic prego)
50
dance
absence of bowel sounds
51
kehr
abdominal pain radiating to left shoulder (spleen rupture, renal calculi, or ectopic prego)
52
romberg-howship
pain medial aspect thight to knee (strangulated obturator hernia)
53
rowsing
RLQ pain worsened by palpation of LLQ (peritoneal irrituation or appendicitis)
54
ballotement
palpation technique use to find/examine floating objects in the body
55
chelecytisis
inflammation of the gallbladder
56
cholelithiasis
stone formation in the gallbaldder
57
colic
spasm in any hollow tubular soft organ accompanied by pain
58
dyschezia
painful or difficult cowel movement
59
dyspepsia
imperfect digestion - not a disease itself but symptomatic of other diseases. vague abd discomfort, sense of fullness after eating, erucation, heartburn, nausea, vomiting, loss of appetite
60
dysphagia
difficulty swallowing
61
hematemesis
vomiting of blood
62
hematochezia
blood in poop
63
icterus
pigmentation of skin and eye (jaundice thing)
64
striae
streaks or lines (with a slivery or purple hue) skin striae result from weakening of the lastic tissue associated with pregnancy, weight gain, rapid growth, and high levels of corticosteroids
65
melena
evacuations resembling tar due to action of intestinal juices on free blood
66
intussusceoption
prolapsing or telescoping of one segment of intestines into another, causing intestinal obstruction
67
aaron
pain or distress occurs in the area of the patients heart or stomach on palpitation of mcburneys point (appendicitis)
68
ballance
fixed dullness to percussion in left flank & dullness in right flank (peritoneal irritatuino)
69
rovsing sgin
right lower quadrant pain is increased with palpation of LLQ | equiv to rebound tenderness

Clinical Med (7 decks)

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