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PDX Abdomen for exam 3

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Question
Answer
what is total absence of bowel sounds a sign of   show
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how long must you listen to bowel sounds for   show
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peritonitis   show
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adynamic ileus   show
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ascites   show
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show palpation technique used to evaluate a structure that is floating by bouncing it gently and feeling it rebound  
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borborygmi   show
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calculi   show
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colic   show
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show diagnosed if pt has 2 or more of following symptoms over course of 3 mos: straining during a bowel mvmnt more than 25% of the time; hard stools more than 25% of the time; incomplete evacuation more than 25% of the time; two or fewer bowel mvmnts in a week  
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show poor diet, dehydration, hypothyroidism, IBS, depression, colon cancer, overuse of laxatives  
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dyspepsia   show
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dysphagia   show
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show accidental passage of bowels  
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hematemesis   show
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show blood that has mixed with acid is dark and clumped  
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high pitched bowel sounds   show
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hypoactive bowel sounds   show
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hyperactive bowel sounds   show
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show passage of dark-colored, tarry stools. due to the presence of blood altered by the intestinal juices  
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peristalsis   show
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puritis   show
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reflux   show
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show yellow, fatty stools. caused by malabsorption syndrome. fat malabsorption is the most obvious. stools are frequent, fatty (yellow), foul smelling, flushing resistant  
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tenesmus   show
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show stretched veins such esophageal varices from cirrhosis  
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show dry mouth. caused by or associated with RA, diabetes, kidney failure, HIV, meds, radiation tx for mouth or throat CA  
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show if divided into 9: epigastric is upper region, umbilical is middle region, and hypogastric or suprapubic is lower region. otherwise just the 4 quadrants  
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what organs are in the RUQ   show
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show stomach, spleen, liver, body of pancreas, L kidney and adrenal, hepatic flexure of the colon, transverse and descending colon  
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what organs are in the RLQ   show
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show descending colon, sigmoid colon, L ovary, L spermatic cord, L ureter  
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show auscultation must be performed prior to palpation. pt must also have an empty bladder prior to the start of the exam.  
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show fluid, fat, feces, flatus, fatal growth, fetus  
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scaphoid abdomen   show
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venous distention in abdominal area   show
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show the 4 quadrants. listen for borborygmi, incr or decr bowel sounds  
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show abdominal aorta, renal aa, common iliac aa, femoral aa. listen for any bruits. also listen to the liver and spleen for any friction rubs  
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name the order of abdominal palpation   show
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McBurney's point   show
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show performed by asking patient to breathe out and gently place hand below costal margin on right side at mid-clavicular line (approx location of gallbladder). pt is then instructed to inspire. pos if pain and stops inspiring - cholecystitis  
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what are some common misdiagnosed tumors of the abdomen   show
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what is the flick the flank test, or puddle sign, used for   show
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normal liver findings   show
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findings of enlarged liver   show
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liver cancer findings   show
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show pneumonia - pus filled lung - empyema. painful problem below the diaphragm (gallbladder). phrenic nerve related problems  
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what is considered a hypomobile liver   show
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show insp: no abnormal findings. ausc: nl bowel sounds, no friction, no ribs, no bruit. percuss: no percussive change (resonant). palp: no placatory discomfort (neg McBurney's, rebound tenderness, Rosvings. special: neg posts and obturator  
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acute appendicitis   show
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show Rovsings - pain in RLQ w pressure in LLQ. rebound tenderness - pain at McBurney's w sudden pressure withdrawal locally (elsewhere in the abdomen). passively stretch psoas: would cause pain in area (& not just a stretch pain)  
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show passive knee and hip flexion with external rotation - a localizing peritoneal sign - pain at McBurney's point  
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irritable bowel syndrome   show
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risk factors of irritable bowel syndrome   show
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show foods, stress, hormones, gastroenteritis - general term for stomach ache  
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show an inflammatory bowel disease in which the rectum and or colon develop ulcers. unknown cause - maybe hereditary or immune compromise.  
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show abdominal pain, diarrhea w blood or puss, rectal bleeding, anemia, fatigue, weight loss, loss of appetite.  
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show obs: finger clubbing unrelated to cardiovascular. ausc: nl bowel sounds but hyperactive bowel sounds when active. percuss: may be more resonant. palp: rigidity noted over the abdomen & may be painless or painful.  
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special tests for ulcerative colitis   show
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active Crohns disease   show
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risk factors of crohns disease   show
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show diarrhea, fever, fatigue, abdominal pain and cramps, bloody stools, anorexia, weight loss, mouth sores  
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show obs: abdominal bloating, oral apthous ulcers. ausc: normal bowel sounds. percuss: resonance unless disease is caused by an underlying tumor. palp: diffuse abdominal tenderness, local pain over affected region; mass palpated bc of thickened/inflamed bowel  
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show insp: cannot see. ausc: cannot hear. percuss: cannot percuss. palp: cannot palpate, non tender  
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show insp: pt may have antalgia and have guarded mvmnts, if they move at all. ausc: friction rubs may occur. percuss: may cause dullness if peritoneal fluid accumulates. palp: severe mm guarding (boardlike rigidity) may accomany  
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phys exam of small intestines (1 of 2)   show
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show percuss: there's nl air in gut - so tympany predominates throughout the abdomen. palp: the soft squishy tubes are not nl palpable  
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show insp: distention. ausc: incr bowel sounds heard in early obstruction & hypoactive or silent later in obstruction. percuss: hyper-tympanic. palp: mm guarding and pain  
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show partial or early obstruction: hyperactive and loud. late partial or total obstruction: hypoactive. paralytic ileus: silent as the grave  
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phys exam of sigmoid colon   show
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hernias   show
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show insp: bulge worse w incr intra-abdominal pressure (cough). ausc: bowel sounds may be incr early, or decr late. percuss: NONE! palp: bulge worse w incr intra abdominal pressure  
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phys exam of gallbladder   show
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show an inspiratory rest sign. a sign of an abnormally tender gallbladder. pt stops inspiration due to incr pain as they breath in. thumb/fingertip pressure is directed toward the gallbladder under the rib margin. very focal pain, no radiation  
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acute cholecystitis   show
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risk factors of cholecystitis   show
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show formation of calculi within the gallbladder. "lith" means "stone"  
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show sharp, cramping pain in RUQ lasting min of 30 min. midback pain or below R shoulder blade. clay-colored stools. fever, nausea & vomiting. yellowing of skin and whites of eyes (jaundice)  
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phys exam of cholecystitis   show
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show normally cannot see. ausc: contributes to bowel sounds. percuss: very tympanic bc of gastric air bubble (magenblase) - typical size and location - NL <2" behind the lower ribs on the L  
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stomach GERD   show
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ssx of stomach GERD must happen 2x/week   show
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peptic ulcers   show
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show excessive alcohol. reg use of aspirin, ibuprofen, naproxen or other NSAIDs. smoking cigarettes or chewing tobacco.  
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ssx of peptic ulcers   show
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what happens if a peptic ulcer becomes too deep   show
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show insp: nl. ausc: nl. percuss: nl. palp: may have burning tenderness in epigastrum, many false positives  
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phys exam of spleen   show
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show insp: may see w deep inspiration. ausc: the spleen remains silent. percuss: area of dullness may expand ant inf as the spleen grows. palp: only becomes palpable if 3x nl size - NEVER squeeze bc it may rupture.  
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how do you palpate the spleen   show
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show lowest rib interspace, anterior axillary line, should stay tympanic when pt breaths in. tap all the way down and it'll go from being very resonant to a very hollow sound as they're taking a breath in if positive  
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show MC if splenomegaly. causes acute blood loss. may irritate the left diaphragm. may cause elevation of the left testicle - Kerr's sign  
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what is Kerr's sign   show
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kidney phys exam   show
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show a special kidney maneuver - pt standing on toes and suddenly drops weight to their heels  
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fist percussion   show
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kidney enlargement phys exam   show
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kidney stones - nephrolithiasis   show
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risk factors of kidney stones   show
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show extreme back or flank pain - renal colic. groin or testicular pain. fever or chills. vomiting. blood in urine. cloudy urine. foul smelling urine. burning urination sensation  
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show obs: no abnormal findings. ausc: hypoactive. percuss: painful kidney punch. palp: during early obstruction may be able to palpate an enlarged kidney (hydronephrotic). placatory tenderness, tenderness at the costovertebral angle  
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show UTIs occur when bacteria ascend the urethra to the bladder. if the bacteria ascends the ureter to the kidneys, it is called pyelonephritis  
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show incr urge and frequency of urination. burning sensation. cloudy urine. bloody urine. could smelling urine. pelvic pain.  
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show obs: no abdominal findings. ausc: no alterations. percuss: no alterations (painful). palp: suprapubic tenderness or pain  
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show abdominal aorta, renal aa, common iliac aa. normally no sounds are produced. abnormal arterial flow causes sounds to be produced - low pitched listened with the bell.  
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show age 65+. smoking. male. genetics.  
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show severe abdominal or back pain. sweating. nausea, vomiting. dizziness, syncope - temp loss of consciousness caused by a fall in blood pressure. tachycardia - rapid, shallow heart rate.  
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veins of the abdomen   show
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