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H&P II > Abdominal > Flashcards

Flashcards in Abdominal Deck (21)
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1
Q

What are u looking for on the general contour of the abdomen?

A

Flat, scaphoid, distended, protuberant

2
Q

What other things are u looking for on inspection of the abdomen?

A

asymmetry, masses, lesions and scars

3
Q

What does caput medusa indicate?

A

heptic cirrosis, IVC obstruction

4
Q

Having the pt flex at the waist allows you to assess for what?

A

Hernias and rectus diathesis

5
Q

What should you do b4 u palpate the abdomen?

A

Auscultate

6
Q

What are normoactive bowel sounds?

A

Clicks and gurgles

Borborygmus: Rumbling of the large bowel

7
Q

What are the frequencies of bowel sounds?

A
Hypoactive
ileus )paralyzed bowel)
peritonitis (must auscultate for 2 minutes)
Normoactive: 5 to 34 per minute
Hyperactive: diarrhea, early obstruction
8
Q

What is borborygmi?

A

Absent with ileus

Increase with obstruction

9
Q

What is high-pitched tinkling?

A

Intestinal air and fluid under high pressure in a dilated bowel

10
Q

What are the 3 places u should auscultate for blood vessels?

A

aorta, renal arteries, iliac arteries

11
Q

What is a venous hum?

A

Rare
Systolic and diastolic
Indicates increased collateral circulation between portal and systemic venous systems
Hepatic cirrhosis

12
Q

What are friction rubs?

A

Rare
Grating which occurs with respirations
Indicate inflammation of peritoneal surfaces
Tumors, infection, abscess, splenic infarct

13
Q

What are the 3 types of resonance on percussion?

A

Dullness: increased with mass, organomegaly
Tympanic ordrumlike: gas in the digestive tract
Hyperresonant: obstruction

14
Q

What should u percuss for on the pt?

A

liver span and bladder height

15
Q

What is light palpation used for?

A

One hand using finger pads

Tenderness, masses

16
Q

What is deep palpation used for?

A
Tenderness
Masses
Hepatomegaly/masses
Begin in the RLQ and work cephalad to the right costal margin
Use rolling hand technique
Kidney
Uterine height
Bladder distension
Size of the aorta
17
Q

3 signs of an acute abdomen?

A

Guarding
Rigidity
Rebound

18
Q

What is the ascites fluid wave test?

A

Patient is supine
Place lateral hands down the abdomen centrally (inhibits transmission through adipose)
Tap one side and feel for transmission in opposite hand

19
Q

What is the ascites shifting dullness test?

A

With patient on back intestinal gas rises toward umbilicus and that area is tympanic
With patient on their side the gas rises tot he lateral area and umbilicus is dull to percussion

20
Q

What is Murphy’s sign?

A

Push up under the right costal margin until just beginning to cause pain
DO NOT MOVE YOUR HAND
Have patient take in a deep breath
Positive sign = patient suddenly halting the deep breath as the inflamed gallbladder touches the fingers

21
Q

How do u test for Nephrolithiasis, Hydronephrosis, and Pyelonephritis?

A

CVA tenderness (Lloyd’s Punch)

Palpate the area first
May illicit tenderness
Place hand over the costovertebral angle
Strike hand, not the patient
Pain suggests inflammation