Flashcards in Abdominal Complaint 1 Deck (43)
What are the types of abdominal pain?
Stimulation of visceral pain fibers
- Secondary to distention or stretching of organs
-- NOT LOCALIZED
Stimulation of somatic pain fibers
- Secondary to inflammation in the parietal peritoneum
Originates within the abdomen but is felt at distant sites which are innervated at same spinal levels as the disordered structure
Important information to get from the HPI?
Aggravating and Alleviating factors
Important information to get from medications?
What is the order of the physical exam for an abdominal complaint?
What must you do to start the physical exam for an abdominal complaint?
Drape your patient
What is the importance of ausciltation?
Bowel sounds - bowel motility information
What do you use to listen (ausiltation) to bowel sounds?
Diaphragm of stethoscope (bigger side)
What are the normal bowel sounds?
5-34 clicks/gurgles per minute
Absent bowel sounds are none for how long?
At least 2 minutes
Decreased bowel sounds are none for how long?
Increased bowel sounds can indicate?
Diarrhea, early bowel obstruction
High pitched bowel sounds can suggest?
Early intestinal obstruction
What does percussion allow you to assess for?
Fluid and solid-filled masses
Amount of gas in the abdomen
Sizing of liver and spleen
Tympany of percussion
High-pitched = air filled
Dullness of percussion
Non-resonating = solid organs or masses or feces
Resonance of percussion
Hollow abdominal organs (lungs)
Hyper-resonance of percussion
Air-filled hollow organ = pneumothorax
Most common percusssion?
Tympany because of gas in GI tract
- Scattered dullness is normal from fluid and feces
Gently palpate in all 4 quadrants and then _____ in all 4 quadrants
When palpating, always start where?
AWAY from area of reported tenderness
Is the spleen normally palpable?
NO, unless enlarged
How can you tell if the liver is enlarged when palpating?
Vertical span is increased
Where do you palpate for the liver?
Right midclavicular line
What is the best test for testing for Ascites?
Test for a fluid wave
Describe the way to test for a fluid wave for Ascites
- Patient rests hands over chest
- Have assistant place ulnar aspects of hands midline
- Place your hands on flanks and tap one flank sharply with finger tips
Normal response for test for a fluid wave for Ascites?
NO impulse felt on other flank