Abdom. Distentions and Referred Pain (RP)

Created by llandini 

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32 terms

Obesity

Uniformly rounded. Umbilicus sunken. Normal bowel sounts. Tympany prevails. Scattered dullness over adipose tissue.

Air or Gas

Inspection: Single round curve.
Auscultation: Depends on cause of gas, e.g. Decreased or absent bowel sounds with ileum; hyperactive with early intestinal obstruction.
Percussion: Tympany over large area.
Palpation: May have muscle spasm of abdominal wall.

Ascites

Inspection: Single curve. Everted umbilicus. Bulging flanks when supine. Taut, glistening skin; recent weight gain; increase in abdominal girth.
Auscultation: Normal bowel sounds over intestines. Diminished over ascitic fluid.
Percussion: Tympany at top where intestines float. Dull over fluid. Produces fluid wave and shifting dullness.
Palpation: Taut skin and increased intra-abdominal pressure limit palpation.

Overian Cyst:

Inspection: Curve in lower half of abdomen, midline. Everted umbilicus.
Auscultation: Normal bowel sounds over upper abdomen where intestines pushed superiorly.
Percussion: Top dull over fluid. Intestines pushed superiorly. Large cyst produces fluid wave and shifting dullness.
Palpation: Transmits aortic pulsation, whereas ascites does not.

Pregnancy

Inspection: Signle curve. Umbilicus protruding. Breasts engorged
Auscultation: Fetal heart tones. Bowel sounds diminished.
Percussion: Tympany over intestines. Dull over enlarging uterus.
Palpation: Fetal parts. Fetal movements

Feces

Inspection: Localized distention
Auscultation: Normal bowel sounds
Percussion: Tympany predominates. Scattered dullness over fecal mass.
Palpation: Plastic-like or rope-like mass with feces in intestines

Tumor:

Inspection: Localized distention
Auscultation:Normal bowel sounds
Percussion: Dull over mass if reaches up to skin surface.
Palpation: Define borders. Distinguish from enlarged organ or nor malling palpable structure.

Liver-RP

Hepatitis may have mild to moderate, dull pain in right upper quadrant or epigastrium, along with anorexia, nausea, malaise, low-grade fever.

Esophagus-RP

Gastroesophageal reflux disease (GERD) is a complex of symptoms of esophagitis, including burning pain in midepigrastrium or behind lower sternum that radiates upward, or heartburn. Occurs 30-60 minutes after eating; aggravated by lying down or bending over.

Gallbladder-RP

Cholecystitisu is biliary colic, sudden pain in RUQ that may radiate to right or left scapula, and which builds over time, lasting 2-4 hours, after ingestion of fatty foods, alcohol, or caffeine. Associated with nausea and vomiting and with positive Murphy sign or sudden stop in inspiration with RUQ palpation.

Pancreas-RP

Pancreatitis has acute, boring midepigastric pain radiating to the back and sometimes to the left scapula or flank, severe nausea, and vomiting.

Duodenum-RP

Duodenal ulcer typically has dull, aching gnawing pain, does not radiate, may be relieved by food, and may awaken the person from sleep.

Stomach-RP

Gastric ulcer pain is dull, aching, gnawing epigastric pain, usually brought on by food, radiates to back or substernal area. Pain of perforated ulcer is burning epigastric pain of sudden onset that refers to one or both shoulders.

Appendix-RP

Appeendicitis typically starts as dull, diffuse pain in periumbilical region that later shifts to severe, sharp, persistent pain and tenderness localized in RLQ (McBurney Point). win is aggravated by movement, coughing, deep breathing; associated with anorexia, then nausea and vomiting, fever.

Kidney-RP

Kidney stones prompt a sudden onset of severe, colicky flank or lower abdominal pain.

Small Intestine-RP

Gastroenteritis has diffuse, generalized abdominal pain, with nausea, diarrhea.

Colon-RP

Large bowel obstruction has moderate, colicky pain of gradual onset in lower abdomen, bloating. Irritable bowel syndrome (IBS) has sharp or burning, cramping pain over a wide area; does not radiate. Brought on by meals, relieved by bowel movement.

Umbilical Hernia

Soft, skin covered mass, which is the protrusion of the momentum or intestine through a weakness of incomplete closure in the umbilical ring.

Epigastric Hernia

A small, fatty nodule at epigastrium in midline, through the line alba.

Incisional Hernia

Bulge near an old operative scar

Diastasis Recti

Seperation of the abdominal rectus muscles

Succussion Splash

Very loud splash auscultated over the upper abdomen when the infant is rocked side to side

Marked peristalsis

with projectile vomiting in the newborn suggest pyloric stenosis

Peritoneal Friction Rub

Rough, grating sound, like two pieces of leather rubbed together, indicates peritoneal inflammation.

Aortic aneurysm

Murmur is harsh, systolic, or continuous and accentuated with systole.

Renal artery stenosis

murmur is midline or toward flank, soft, low to medium pitch.

Enlarged liver

Cirrhosis, obstruction of vena cava, lymphocytic leukemia

Enlarged nodular liver

Late portal cirrhosis, metastatic cancer, tertiary syphilis

Enlarged gall bladder

Gallstones, bile duct obstruction

Enlarged spleen

Acute: Mono; enlarged and soft
Chronic: Inflamed peritoneum; firm or hard

Enlarged kidney

hydronephrosis, cyst, neoplasm

Aortic Anuerysm

Pulsation mass in upper abdomen, hear a bruit

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