Week 9 Abdominal Flashcards Preview

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Flashcards in Week 9 Abdominal Deck (51):
1

When taking a health history of the abdomen what questions should you ask?
6 points

1. heartburn
2. constipation
3. nausea
4. vomiting
5. diarrhea
6. blood in the stool or general changes in frequency or pain

2

Hematochezia

Bleeding from rectum

3

What medications do you ask the patient about

stool softeners

4

Questions for abdominal pain

OLDCARTS
2. What was the last meal you had?
3. What do you believe may have caused the pain?

5

Older Adult specific questions

1. How do you get your groecies?
2. How do you prepare your meals
3. Do you eat alone or share your meals
4. Do you have trouble eating or swallowing
5. How much liquid do you have
6. Bowl habits
7. Fiber in diet
8. Do you take meds for constipation

6

What things do we need to prevent consitpation

Fiber
Exercise
Fluids

7

Areas to assess for that might impact nutrition

1. Changes in taste, smell, appetite, chewing, swallowing
2. Recent surgeries, trauma, burns, infections
3. Eating patterns
4. usual weight for the PT
5. Nausea, vomiting, diarrhea, constipation
6. Allergies or intolerances
7. Medications and nutritional supplements
8. self care behaviors
9. Exercise?

8

What factors do we assess for when determining if someone can eat?

1. money
2. transportation
3. SES
4. teeth
5. Ability to consume
6. Access to foods
7. Do you need someone to prepare the food for you

9

Assessing Dietary Intake

1. 24 hour recall
2. Food Frequency Questionnaire
3. Food Diary
4. Direct Observation

10

For hospitalized patients what is the best way to assess nutrition

Calorie counts of nutrients and everything that is infused

11

What organs are located in the upper right quadrant

liver
gallbladder
duodenum
head of the pancreas
right kidney & adrenal glands
Hepatic flexure of colon
part of ascending and transverse colon

12

What organs are located in the upper left quadrant

stomach
spleen
left lobe of liver
left kidney and adrenal gland
splenic flexure of colon
part of the transverse and descending colon

13

Right lower Quadrant

cecum
appendix
right ovary and tube
right ureter
right spermatic cord

14

left lower quadrant

part of the descending colon
sigmond colon
left ovary and tube
left ureter
left spermatic cord

15

Midline organs

aorta
uterus ONLY IF ENLARGED
Bladder IF DISTEND

16

Steps for assessment of the abdomen

Inspection
Auscultation
Percussion
Palpation

17

4 things to ask for bowl movements

date of late one
# of stool in the last 24 hours
description of stool
incontinence?

18

assessment of the abdomen light palpation

soft, firm, distended
tender or non tender

19

Abdominal sounds

normoactive
hypoactive
hyperactive
in all four quads

20

Assessment of the mouth

-dentition
-dentures
-ulcers
-cracks
-fissures

21

Demeanor of the patient during assessment

comfortable and relaxed
absolutely still
restless and constant turning

22

Scaphiod

position when the PT is laying down and their stomach is dented inward after the ribs

23

Protuberant

Abdomen is sticking out when the person is supine

24

other then the flat, distended, round inception of the stomach what other things can be observed

bulges
massess
hernias
enlarged liver
enlarged spleen

25

Umbilicus assessment- abnormal findings

-everted:could indicate signs of ascities and hernia
-sunken (obesity)
-blush (cullen sign)

26

Pulsation or movement in the stomach- both normal and abnormal

normal- abdominal aorta pulsations, respirations
abnormal- excessive aorta pulsations could indicate aortic aneurysm or hypertention

27

Hair distribution

-normal- alterations in hair due to endocrine or hormone abnormalities
-normal- diamond shape hair in men and inverted triangle in women

28

how long do you listen for bowl sounds before you can say they are absent?

2 minutes

29

how do you assess the abdominal burits

-use the bell
-this is an abnormla vascular sound

30

Abdominal bruits 3 places or arteries in which they can be heard if present

-aortic aneurysm
-renal artery stenosis
-femoral artery occlusions

31

what should you note if you feel you heard a bruit

location
pitch
timing-systolic bruit which could be caused by stenosis or occlusion

32

Percussion - normal sound

general tympany aka hallow drum like sound

33

which areas of the abdomen should be dull upon percussion

-if you percuss over the liver, spleen or adipose tissue

34

dullness over areas other then where it is normal would indicate what?

- fluid
-mass
-distended bladder

35

what sound would you hear during percussion over gaseous distention

hyperresonance

36

Costovertebral angle tenderness

indicates kidney inflammation

37

what are you palpating for in the abdomen? 4 things

-muscle guarding
-rigidity
-large massess
-tenderness

38

Light palpation technique

-use four fingers
-gentle circular motion
-1 cm deep
- do not drag over the area.

39

What variations exist when assessing someone who is obese?
-inspection
-auscultation
-palpation

-inspection- uniformly rounded with sunken umbilicus
-auscultation- normal
-percussion- possible dullness over the adipose tissue
-palpation- normal but may be difficult to feel through the abdominal wall

40

how does air or gas in the abdomen look like?
& is auscultation impacted by the presence of gas?

- single rounded curve
-depends on the cause for the gas

41

with the presence of gas would you have any differences on percussion and palpitation?

-percussion would be tympana over large area
-palpation could possibly cause muscle spams

42

Ascities- inspection

-inc abdominal girth
-taut skin
-single curve and everted umbilicus
bulging flanks

43

ascities ausculation

normal over the bowl sounds but diminished over areas of fluid

44

Ascities- percussion

tympany over the bowls but dull over the fluid

45

ascities- palpation

tait skin and you would feel increased pressure

46

feces- abdominal inspection

-see a localized distention

47

feces- abdominal auscultation

normal

48

feces- percussion

-tympany with dullness over the fecal mass

49

feces papation

rope like mass with be felt
-if feces in colon it would be felt in the lower left quad

50

health promotion for swallowing- what service access do we have

swallow therapy

51

health promotion- what three common abdomal related medications is PT education good to give for

-antacids
-stool softeners
-laxatives