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Physical Diagnosis
Abdominal
| Question | Answer |
|---|---|
| What might back pain at the CVA be? | Kidney problem, or in men referred pain from prostate |
| Where does the aorta bifurcate? | Level of umbilicus |
| Is bladder palpable? | When distended. |
| Where do you percuss the posterior kidneys? | At the CVA. |
| What is the order for the abdominal exam? | Inspect, AUSCULTATE, Percuss, Palpate |
| What can be noted with aneurysm? | Increased aortic pulsation |
| What are bulging flanks and a venous pattern on abdomen signals of? | Fluid in peritoneal space consistent with liver disease. |
| Name four bruits you must auscultate for. | Renal, aortic, iliac, femoral. |
| How long must you listen in each ab quadrant before concluding that bowel sounds are absent? | At least two minutes. |
| What is a Borborygmi? | loud stomach growls |
| What is the absence of bowel activity and sounds due to a direct insult to the gut? | Paralytic Ileus |
| Where do you percuss spleen? | Lowest interspace in lt anterior axillary line |
| What is shifting from typmany to dullness with inspiration suggestive on when percussing the spleen? | This is a positive splenic percussion sign suggestive of enlarged spleen. |
| What do bilaterally enlarged kidneys suggest? | Polycystic disease |
| What are three causes of enlarged kidney? | Hydronephrosis, cysts, tumor |
| Where do you press to idenitify aortic pulsations? | Left of midline. |
| What might a pulsatile upper abdominal mass suggest? | Aneurysm |
| What three tests check for ascites? | Shifting dullness, fluid wave, Ballotte |
| What is Murphy's sign, and what is it indicative of? | Pain over gall bladder as you press while pt inspires; acute cholecystitis |
| What may be accentuated by pt lifting head? | Hernia |
| Describe visceral pain. | gnawing, cramping, aching, difficult to localize, may be cetered around umbilicus - hepatitis |
| Describe parietal pain | more severe, easy to localize, may come with nausea, vomitting, anorexia, is localized over area of inflammation; appendicits |
| Where might gallbladder pain be referred to? | Shoulder. |
| What are some signs of parietal pain in the acute abdomen? | Decreased bowel sounds, rebound tenderness, guarding, rigidity, hypersneitivity |
| Where does appendicitis pain often start, and where does it move? | Periumbilical to RLQ |
| What may increase pain in appendicitis? | Cough |
| What is the test for appendicitis? | Point tenderness of McBurney's point, Psoas Sign, Rovsing Sign (or rebound pain, cutaneous hypersthesia) |
Created by:
adhass