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Advanced Health Assessment > Week 2 Abdomen > Flashcards

Week 2 Abdomen Flashcards

1
Q

Common or concerning symptoms of GI disorders

A

Indigestion
Nausea
Vomiting
Hematemesis
Abdominal pain
Dysphasia
Odynophobia
Change in bowel functions
Constipation
Diarrhea
Jaundice

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2
Q

Ask the patient about bowel movements

A

Frequency of BMs
Consistency
Pain with BM
blood, black/tarry stool
Color
Jaundice

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3
Q

History taking of problems of the abdomen

A

Prior medical problems related to abdomen
Surgeries of abdomen
Any foreign travel and occupational hazards
Use of tobacco, alcohol, illegal drugs
Med history
Hereditary disorders
Regurgitation
Vomiting

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4
Q

History taking of problems of abdomen: urinary tract

A

Frequency
Urgency
Pain
Color and smell
Difficulty starting
Leakage
Back pain

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5
Q

Visceral (somatic or nociceptive) pain

A

Forceful contraction or distention of hollow organs (stomach, colon). Solid organs (liver, spleen) can also generate this type of pain when they swell against their capsules

Gnawing cramping colicky aching

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6
Q

Parietal pain (inflammatory)

A

Inflammation from the hollow or solid organs that affect the parietal peritoneum. Parietal pain is more severe and is usually easily localized (ex appendicitis)

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7
Q

Referred pain

A

Originates at different sites but shares innovation from the same spinal level

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8
Q

Abdominal exam rubric

A

Inspect
Auscultation
Percuss
Light palpate
Deep palpate
Palpate other organs

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9
Q

Tympany

A

High pitched musical sound that indicates a hollow space filled by air or gas in stomach/intestines

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10
Q

Dullness

A

Suggests fluid or underlying organs like spleen or liver

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11
Q

Signs of acute abdomen

A

Abdominal pain with coughing
Rigidity
Guarding
Rebound tenderness
Percussion tenderness

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12
Q

Costovertebral angle (CVA)

A

Ulnar side of first lightly tap to note tenderness

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13
Q

Obturator sign

A

+ pain with inward rotation of hip with knee bent

Flip on left side, bring leg into flexion

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14
Q

Psoas sign

A

+pain with hand on thigh, ask patient to raise in opposition; contracts psoas muscle and produces pain in RLQ

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15
Q

Rovsings sign

A

+rebound tenderness of RLQ on palpitation of LLQ

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16
Q

3 techniques to determine appendicitis

A

Obturator sign
Psoas sign
Rovsings sign

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17
Q

Inspection of Abdomen

A

contour
pulsations or peristalsis visible
scars, ecchymoses, rashes
umbilicus

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18
Q

Ausculatation of Abdomen

A

all 4 quadrants
note quality and frequency of sounds
normal- 5-34 /min

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19
Q

Borborygmi

A

stomach growling
hyperperistalsis
can hear without stethoscope

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20
Q

mcburney’s point

A

appendicitis

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21
Q

Murphy’s sign

A

cholecystitis
+ pain on palpation RUQ, just under ribs

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22
Q

Grey Turner’s sign

A

pancreatitis
discoloration of left flank
rare

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23
Q

Cullen’s sign

A

pancreatitis
discoloration surrounding umbilicus

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24
Q

Somatic/visceral/tension pain

A

caused by an increased forcefulness of peristaltic contraction–> acute stretching of an organ capsule

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25
inflammatory pain
caused by inflammation of peritoneum starts generalized, later localizes to location of organ deep, intense pain worsening with movement or coughing
26
examples of possible diagnoses for somatic/visceral/tension abdominal pain
bowel obstruction, gastroenteritis, food-related
27
examples of possible diagnoses for inflammatory abdominal pain
appendicitis, cholecystitis, pancreatitis
28
ischemic abdominall pain
caused by inceased O2 demand and decreased O2 supply in the gut deep intense continuous pain worsening with actiivities that increase O2 demand such s eating
29
examples of possible diagnoses for ischemic abdominal pain
ischemic bowel, mesenteric artery, ischemia/infarct
30
warning signs of "surgical abdomen"
intractable pain acute, progressive pain over time pain causing syncope or disturbing sleep old surgical scars on the abdomen localized pain
31
cholecystitis definition
inflammation of gallblader
31
subjefctive findings of cholecystitis
acute pain in RUQ with radiation to R shoulder N/V subjective fever
31
historical risk factors of cholecystitis
prior gallbladder disease, family history, recent fatty meal, acute illness, >40, females>males
32
objective/physical exam findings for cholecystits
+murphy's sign low grade fever jaundice
33
diagnostics for cholecystitis
RUQ US HIDA scan liver enzymes, WBC, CRP
34
historical findings for pancreatitis
alchohol abuse * HLD medication induced (Diabetetes) vascular disease hyperparathyroidism and hypercalcemia renal transplant pt
35
subjective findings for pancreatits
severe abdominal pain (RUQ or Epigastric) with radiation to the back severe N/V subjective fever
36
physical exam for pancreattisis
abdominal tenderness/distention, hypoactive bowel sounds, signs of severe disease/shock, diaphoresis
37
diagnostics for pancreatitsi
high amylase and lipase leukocytosis CT scan abdominal Xrays
38
historical findings for appendicitis
common ages 10-30 gynecologic disorders aned gastroenteritis commonly present as appendicitis peritonisits development in approx 36 hours
39
subjective findings for appendicitis
severe RLQ pain nausea loss of appetitie feeling need to defecate increased pain with movement or cough subjective fever
40
objective findings for appendicitis
RLQ rebound tenderness rosvings sign, obturator sign, psoas sign fever
41
diverticulitis
inflammation of a diverticulum
42
historical findings for diverticulitis
>60 connective tissue disease marfan syndrome chronic constipation history of diverticula
43
subjective findings for diverticulitis
generalized LLQ pain subjective fever constipation or diarrhea N/V very GENERAL symptom
44
diagnostics for diverticulitis
CT scan can confirm, but usually done by clinical diagnosis +stool for occult blood leukocytosis abdominal film colonoscopy once less inflammed 7-10 days
45
historical risk factors for GERD
medication use common triggers such as citrus, tomatoes, caffeine, alcohol, chocolate smoking obesity
46
GERD
the lower esophageal sphincter decreased resting tone, it allows gastric contents to go back up into the esphageal area and that relaxation that causes GERD
47
subjectie findings for GERD
heartburn relieved by antacids frequent belching cough,wheeze,aspiration,hoarseness, sensation of globus
48
diagnostics for GERD
clinical diagnosis trial of PPI endoscopy if not resolved
49
historial risk factors for PUD
h pylori infection NSAID use systemic corticosteroid use age >50-55
50
differences between gastric ulcer and duodenal ulcer
gastric- pain worsens after eating duodenal- improves with eating
51
indications for EGD
Bleeding odynophagia weight loss (unplanned) early satiety dysphagia
52
historical risk factors of ectopic pregnancy
endometrisis, multiple D&Cs, abortions, history of tubal infection, infertility, PID, previous tubual surgery, IUD
53
subjective findings of ectopic pregnancy
amenorrhea followed by spotting sudden onsent of sever elower abdominal pain back pain
54
physical exam for ectopic pregnancy
tenderness on pelvic exam with palpable mass and blod in he pculdesac abdominal distention with peritoneal signs
55
diagnostics for ectopic pregnancy
urine or serum hCg pelvic US immediate surgery if rupture
56
urinary calculi historical factors
men>women heavy sodium/protein diet hot humid climate fam history
57
subjective findings of urinary calculi
pain in flank, RLQ, LLQ, suprapubic area severe acute colicky pain N/V urgency or frequency report of hematuria
58
physical exam for urinary calculi
CVA tenderness otherwise normal
59

Advanced Health Assessment (8 decks)

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