Pt Assess II Final > Abdominal Lecture > Flashcards

Abdominal Lecture Flashcards

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1
Q

Where does the abdominal cavity extend from?

A

Just below diaphragm to the symphysis pubis

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2
Q

How are the 4 quadrants of the abdomen drawn?

A
  • Vertical line through umbilicus

- Horizontal across umbilicus

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3
Q

Define anorexia

A

Loss of appetite

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4
Q

What can early satiety indicate?

A

Gastric outlet obstruction
Hepatitis
Diabetic gastroparesis

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5
Q

What GI-related things can cause unintentional weight loss?

A
  • Malignancy
  • Malabsorption
  • Liver disease
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6
Q

Define dysphagia

A

Difficulty swallowing

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7
Q

Define odynophagia

A

Painful swallowing

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8
Q

How can heartburn radiate?

A

To neck and epigastrum

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9
Q

Mechanical causes of dysphagia

A
  • Stricture
  • Cancer or mass
  • Obstruction (FB)
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10
Q

Motor causes of dysphagia

A
  • Neuro disorder
  • Spasm
  • Scleroderma
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11
Q

If a patient points to their throat, they usually have a/an ___ problem

A

Transfer

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12
Q

If a patient points to their chest (and it is suspected GI related), then it is often a/an ____ problem

A

Esophageal

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13
Q

Define transfer dysphagia

A
  • Swallowing is attempted
  • Results in aspiration of food into nose/lungs
  • Suggests CNS problem
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14
Q

Define achalasia

A

Esophageal musculature does not relax enough

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15
Q

Regurgitation of food bolus suggests ____ problem

A

Mechanical

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16
Q

Intermittent solid to liquid mechanical dysphagia suggests:

A

Stricture

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17
Q

Intermittent solid then progressing to liquid mechanical dysphagia and progressively worsening with pain suggests:

A

Esophageal cancer

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18
Q

What are common causes of odynophagia?

A
  • Esophagitis (GERD induced)
  • FB
  • Pharyngitis (MC)
  • Achalasia
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19
Q

What is the MC cause of odynophagia?

A

Pharyngitis

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20
Q

Sharp and burning odynophagia suggests:

A

Mucosal inflammation (reflux esophagitis or infection)

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21
Q

Sharp and sticking odynophagia suggests:

A

Mechanical (fish or chicken bone)

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22
Q

Squeezing/cramping odynophagia suggests:

A

Muscular (esophageal spasm, achalasia)

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23
Q

Define regurgitation (GI)

A

Bringing up gastric contents without nausea or vomiting

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24
Q

What can cause fecal-like material to be vomited?

A

Small bowel blockage or fistula

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25
Presence of bright red blood in vomitus indicates:
Esophageal or upper GI bleed
26
Presence of coffee ground material in vomitus indicates:
Partially digested blood (altered by stomach acid)
27
Prolonged vomiting will cause:
Fluid and electrolyte imbalance
28
Aerophagia can cause:
Excessive belching/flatulence
29
Define obstipation
Constipation occurring as a result of intestinal obstruction
30
Large volumes of osmotic (watery) diarrhea can indicate:
Lactose intolerance
31
Soft, watery with blood diarrhea indicates:
IBD (ulcerative colitis)
32
Small, soft, watery w/o blood diarrhea indicates:
Crohn's disease
33
Melena means:
Blood has passed through digestive tract | black, tarry stools
34
Jaundice can be accompanied with:
Severe itching
35
Jaundice is caused by:
Hepatic disease or lysis of RBCs
36
Jaundice causes elevated levels of ____ in the blood
Bilirubin
37
How do urine and stool change with jaundice?
- Urine becomes like tea | - Stools become light yellow or gray
38
Stretching of liver capsule can cause ____ pain
Visceral
39
Quality of visceral pain
- Cramping colicky - Crescendo/decrescendo - Can be related to intestinal peristalsis - Usually not well localized by pt
40
Severe visceral pain can be accompanied by:
- NV - Sweating - Pallor - Restlessness (writhing)
41
Function of mesentery
Acts as conduit for BV, nerves, lymphatics usually supported in layers of fat
42
Describe parietal pain
- Inflammation of parietal peritoneum - Aka somatic pain - Steady, aching, severe (worse than visceral) - Well localized - Aggravated by movement (pts lie still!)
43
How does acute appendicitis pain present?
- Initially, periumbilical visceral pain | - Gradually, parietal pain well localized to RLQ as inflammation spreads
44
Define referred pain
- Pain from original site radiates to distant site - Often at same spinal level as affected structure - May be superficial or deep - Well localized
45
Abdominal pain is a (reliable/unreliable) guide to severity?
Unreliable - depends on patient | -Chronology may be more useful
46
How is abdominal contour described?
- Flat - Protuberant - Scaphoid - Obese
47
Visible peristalsis can be an early sign of:
Obstruction
48
Define diastasis recti
Separation of rectus abdominis muscles in midline creating a ridge when pt lifts head and shoulders off flat surface -Not pathological
49
Describe ascites
Free fluid collection in abdomen
50
Hyperactive bowel sounds can indicate:
- Diarrhea | - Early obstruction
51
Hypoactive bowel sounds can indicate:
- Paralytic ileus | - Early peritonitis
52
Absent bowel sounds indicate:
- Complete obstruction | - Late peritonitis
53
Gas produces what note of percussion?
Tympanic
54
Liquid produces what note of percussion?
Dull
55
Solid produces what note of percussion?
Even more profound dullness than liquid
56
Areas that contain both gas and fluid will produce what note of percussion?
Lower pitched tympanic
57
Most notable areas of abdomen for percussion?
- Gastric bubble (LUQ, tympanic) - Colonic splenic flexure (LUQ, low tympanic) - Liver (RUQ, dullness)
58
What does abdominal muscular rigidity indicate?
Peritoneal irritation
59
How are abdominal masses classified?
- Physiologic (pregnant uterus) - Neoplastic (tumors) - Vascular (AAA) - Inflammatory (diverticulitis)
60
What does rebound tenderness indicate?
Presence of peritoneal inflammation
61
A normal size liver may be palpable up to ___ cm below the ____
3 cm below costal margin (in mid-clavicular line)
62
Describe a normal liver edge
Smooth, soft
63
What is the purpose of the scratch test?
Can help to locate lower liver margin
64
Where does the spleen lie?
Between left 10th rib (LUQ)
65
Purpose of psoas sign
- Tests for appendicitis | - Abdominal pain occurs due to inflamed psoas muscle
66
Describe Rovsing's sign
- Aka indirect tenderness - Rebound tenderness in LLQ - Positive in appendicitis
Pt Assess II Final
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