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Flashcards in Abdominal Complaint 1 Deck (43)
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1

What are the types of abdominal pain?

Parietal pain
Visceral pain
Referred pain

2

Visceral pain

Stimulation of visceral pain fibers
- Secondary to distention or stretching of organs
-- NOT LOCALIZED

3

Parietal pain

Stimulation of somatic pain fibers
- Secondary to inflammation in the parietal peritoneum
-- LOCALIZED

4

Referred pain

Originates within the abdomen but is felt at distant sites which are innervated at same spinal levels as the disordered structure

5

Important information to get from the HPI?

Location
Aggravating and Alleviating factors

6

Important information to get from medications?

Blood thinners
NSAIDS
Narcotics, steroids

7

What is the order of the physical exam for an abdominal complaint?

1. Inspection
2. Auscultation
3. Percussion
4. Palpation

8

What must you do to start the physical exam for an abdominal complaint?

Drape your patient

9

What is the importance of ausciltation?

Bowel sounds - bowel motility information

10

What do you use to listen (ausiltation) to bowel sounds?

Diaphragm of stethoscope (bigger side)

11

What are the normal bowel sounds?

5-34 clicks/gurgles per minute

12

Absent bowel sounds are none for how long?

At least 2 minutes

13

Decreased bowel sounds are none for how long?

1 minute

14

Increased bowel sounds can indicate?

Diarrhea, early bowel obstruction

15

High pitched bowel sounds can suggest?

Early intestinal obstruction

16

What does percussion allow you to assess for?

Fluid and solid-filled masses
Amount of gas in the abdomen
Sizing of liver and spleen

17

Tympany of percussion

High-pitched = air filled

18

Dullness of percussion

Non-resonating = solid organs or masses or feces

19

Resonance of percussion

Hollow abdominal organs (lungs)

20

Hyper-resonance of percussion

Air-filled hollow organ = pneumothorax

21

Most common percusssion?

Tympany because of gas in GI tract
- Scattered dullness is normal from fluid and feces

22

Gently palpate in all 4 quadrants and then _____ in all 4 quadrants

Deeply palpate

23

When palpating, always start where?

AWAY from area of reported tenderness

24

Is the spleen normally palpable?

NO, unless enlarged

25

How can you tell if the liver is enlarged when palpating?

Vertical span is increased

26

Where do you palpate for the liver?

Right midclavicular line

27

What is the best test for testing for Ascites?

Test for a fluid wave

28

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

29

Normal response for test for a fluid wave for Ascites?

NO impulse felt on other flank

30

ABnormal response for test for a fluid wave for Ascites?

(+) = impulse transmitted to the other flank