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HA abdomen hc
HA abdomen ch 24
| Question | Answer |
|---|---|
| functions of abdomen | protection/support digestion/absorption waste elimination movement/posture breathing hormone production immune system pregnancy support |
| abdomen bordered | superiorly - costal margins inferiorly - symphysis pubis/inguinal canals laterally - flanks |
| quadrants of abdomen | RUQ/RLQ LUQ/LLQ |
| abdominal regions | epigastric umbilical hypogastric suprapubic |
| RLQ organs | appendix ascending colon/cecum right kidney/ureter right ovary/tube right spermatic cord |
| RUQ organs | ascending/transverse colon and hepatic flexure (colon) duodenum liver/GB/pancreatic head pylorus right kidney/adrenal gland/ureter |
| LUQ organs | left kidney/adrenal gland/ureter pancreas spleen stomach transverse/descending colon |
| LLQ organs | left kidney descending/sigmoid colon left ovary/tube left spermatic cord |
| abdominal wall muscles | external/internal abdominus oblique transverse abdominius protect internal organs and compression of organs during activities |
| peritoneum | continuous membrane lining abd/pelvic cavities and organs protective barrier organ support (nerves/vasculature/lymphatic vessels) |
| parietal peritoneum | lines inner surface of abd wall |
| visceral peritoneum | covers abdominal organs like intestine/stomach/liver |
| solid organs | liver pancreas spleen adrenal glands/kidney ovaries/uterus |
| hallow organs | stomach GB intestine/colon bladder |
| PUD modifiable risk factors | NSAID/bisphosphonate use smoking/tobacco chewing EtOH use uncontrolled stress spicy food |
| PUD non-modifiable risk factors | H. Pylori infection serious illness (respirator use) hypersecretory condition FHx gastric ulcer radiation Tx Zollinger-Ellison Syndrome (ZES) |
| Zollinger-Ellison Syndrome | gastrinomas form in pancreas/duodenum -> secrete excessive gastrin consequence: PUD formation, diarrhea, abdominal pain, weight loss |
| gastrin | hormone that stimulates stomach to produce acid |
| PUD client education | H. Pylori prevention - handwashing/cook food thoroughly NSAID/pain medication caution EtOH intake (>1 drink in women and >2 drinks men daily) tobacco use |
| H. Pylori transmission route | fecal-oral route saliva, vomit, stool contaminated foods/water |
| GERD risk factors | obesity hiatal hernia smoking/asthma EtOH pregnancy DM large/late meals gastroparesis/delayed stomach emptying dairy/spicy/fried food pharmaceutical |
| SBO | small bowel obstruction partial vs complete blockage |
| common causes of SBO | adhesion (surgical scar tissues) hernia tumor inflammatory conditions (Crohn's) intussusception |
| intussusception | when pat of intestine slides into another part |
| symptoms of SBO | abdominal pain/distension N/V difficulty passing gas/stool |
| Dx for SBO | Physical exam XR/CT imaging blood work |
| tx for SBO | bowel rest fluid surgical intervention |
| DKA | diabetic ketoacidosis occurs d/t insufficient insulin supply -> fat metabolism (ketone byproduct) |
| AAA | abdominal aortic aneurysm bulge/swelling in aorta usually asymptomatic; life threatening if >5 cm -> aortic rupture/massive hemorrhage |
| PUD | peptic ulcer disease ulcerations of stomach/duodenum |
| PMHx consideration for abdomen | surgical Hx trauma/injury medications labs/GI studies (ie. endoscopic/imaging studies) |
| FHx consideration for abdomen | GI cancer (stomach/colon/liver) appendicitis colitis familial nutritional habits |
| subjective data consideration for abdomen | weight gain loss N/V appetite bowel movements indigestion pain descriptor/other symptoms |
| lifestyle considerations for abdomen | smoking/EtOH diet/fluids antacid use medication use exercise stress |
| equipment for physical exam (abdomen) | pillow/rolled blanket centimeter ruler stethoscope marking pen |
| inspection of abdomen | skin - color, vascularization, striae, scar, lesions abdominal contour/symmetry aortic pulsations peristaltic waves |
| auscultation of abdomen | bowel sounds every 5-15 seconds minimum 1 minute to 5 minutes to confirm absence of bowel sounds bruits over abd aorta; renal/iliac/femoral arteries liver/spleen friction rub |
| friction rub | grating/squeaking sound indicate inflamed/roughened surface rubbing against each other |
| causes of friction rub | chest trauma autoimmune disease (RA or lupus -> serositis) |
| percussion of abdomen | percuss tone (tympany/dullness) percuss span/liver height -> determine upper/lower border percuss spleen blunt percussion of B/L kidneys |
| consideration for abdominal palpation | percuss tender/painful areas last light palpation before deep overcome ticklishness/voluntary guarding via self palpation (finger over client's) |
| palpation of abdomen | light palpation (1 cm deep) -> deep palpation (5-6 cm deep) palpate from RLQ -> RUQ -> LUQ -> LLQ palpate for masses palpate umbilicus/surrounding area for mass/swelling/bulges |
| sequence for abdominal assessment | inspection -> auscultation -> percussion -> palpation |
| target organs of palpation | aorta liver spleen kidney urinary bladder |
| ascites testing | test for shifting dullness fluid wave testing |
| fluid wave test | tapping flank while feeling for fluid wave on opposite flank positive test suggest ascites but require US/CT confirmation |
| appendicitis testing | hypersensitivity test Psoas sign |
| Psoas sign | raise right leg from hip and hold leg up while while pressing down on thigh |
| rosving's sign | referred pain on the left lower abdomen in appendicitis |
| test for cholecystitis | RUQ pain or tenderness Murphy's sign paint when breathing or out |
| visceral pain | pain originating from organs can be referred sharp, localized pain |
| parietal pain | irritation of the peritoneum usually sharper pain more localized -> intensified by movement/coughing/sneezing/pressure |
| referred pain | sensation of pain distant from actual source of pain -> nervous system misinterprets pain signals |
| causes of visceral pain | organ distension ischemia gastric issues (gastroenteritis/IBS/Gastritis) |
| causes of parietal pain | peritoneal inflammation surgical incisions trauma/injury infection/abscess |
| causes of abdominal distension | pregnancy - normal fat feces fibroids/masses flatus ascitic fluid |
| abdominal bulges | umbilical hernia epigastric hernia incisional hernia diastasis recti |
| enlarged abdominal organs | enlarged liver (or nodular liver) enlarged spleen aortic aneurysm enlarged kidne enlarged GB |
| older client considerations (abdomen) | dilated superficial capillaries multifactorial anorexia d/t age + conditions = risk for nutritional imbalance diminished pain sensitivity higher fat to lean muscle ratio = complications with diarreha |
| older client physiologic change considerations | fat distribution in abdomen/hips decreased salivation decreased gastric acid secretion = pernicious anemia delayed esophageal emptying increased GB stone decrease liver size with age |
| data analysis | wellness diagnosis risk diagnosis actual diagnosis collaborative problems |
Created by:
sleepingbear
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