abd nml

Question 1

what is the order of examination of the stomach

Answer 1

• inspect
• auscultate
• percuss
• palpate

Question 2

what side should you stand on when examining the abdomen

Answer 2

stand on the patient’s right side

Question 3

what are you auscultating

Answer 3

• all 4 quadrants for bowel sounds (diaphragm)
• aorta for bruits
• femoral arteries

Question 4

measure span between the lower and upper borders of the liver in what region?

Answer 4

right midclavicular line

Question 5

how do you find the lower border of the liver

Answer 5

• begin at the level of the umbilicus in the midclavicular line and percuss towards the liver
• note where dullness begins
• liver edge is usually just at or below costal margin
• mark with pen

Question 6

how do you find the upper border of the liver

Answer 6

• begin at about the 4th ICS and percuss inferiorly to area of dullness (usually 5-7th ICS)
• mark with pen

Question 7

what is the normal span of the liver

Answer 7

6-12 cm in the MCL

Question 8

what are you looking for in palpating the abdomen

Answer 8

• muscle spasm
• masses
• fluid
• areas of tenderness

Question 9

what are the techniques for liver palpation

Answer 9

1. right fingers placed on RUQ a few cm below costal margin
2. left hand placed on rt low back
3. fingers pointed toward patients right shoulder
4. have a pt take a deep breath and feel for liver edge as it moves down with inspiration
5. palpate during inspiration

Question 10

how do you examine the spleen

Answer 10

1. stand on pt’s right side and reach across abd
2. right hand at LUQ just below costal margin, with fingers pointing toward left lateral chest
3. left hand behind ribcage in low back
4. have patient take a deep breath
5. palpate during inspiration

Question 11

how do you examine the kidney for tenderness

Answer 11

• patient is sitting
• use gentle fist percussion at the R and L costovertebral (near the spine)

Question 12

how you do examine the kidney for size

Answer 12

• supine
• right hand on anterior abdomen, palpate deeply to the right and left of the arota in the kidney region
• reach around the back with your left hand in the small of the back and lift forward so kidney is pulled slightly anteriorly

Question 13

how do you examine the aorta

Answer 13

• palpate just left of the midline, between xiphoid and ubilicus
  
  • apply steady downward pressure with fingertips, one hand on either side of the aortic impulse

Question 14

what aortic size makes you suspicious for a AAA

Answer 14

> 3 cm