PDX : Abdomen

Minimum amount of time you must listen for presence of bowel sounds. If you hear none, what are you suspecting?
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Minimum amount of time you must listen for presence of bowel sounds. If you hear none, what are you suspecting?
2-5 minutes, if none suspect peritonitis, adynamic ileus, perforated duodenal ulcer following surgery.
Excessive fluid build up in the abdomen is known as what? Indicative of?
Ascites, indicates liver disease/cirrhosis
Palpation technique of bouncing a floating structure gently and feeling it rebound.
Ballottement
Prolonged audible abdominal sounds produced by gas moving through intestines.
Borborygmi
Stones / solid lumps in digestive tracts are known as?
Calculi
Attacks of abdominal pain caused by muscle spasms in the intestines is known as?
Colic
Indigestion is also known as?
Dyspepsia
Problem swallowing food or liquid, usually by blockage to the esophagus
Dysphagia
Accidental passage of bowel
Encopresis
High pitched bowel sounds may be a sign of what?
Early bowel obstruction
After taking medications or following abdominal surgery, would you expect hyperactive or hypoactive bowel sounds?HypoactiveWavelike movement of muscles in the GI tract is known as?PeristalsisCondition where gastric juices or small amounts of food from the stomach flows back into the esophagus and mouth.Reflux / RegurgitationStraining to have a bowel movement, sometimes painful, is also known as?TenesmusStretched veins, an example would be esophageal ______ from cirrhosisVaricesAlso known as dry mouth, shown in RA, diabetes, kidney failure, etc.XerostomiaName three structures in the RUQ1) Liver 2) Gallbladder 3) Right kidney and adrenal (May be more)Name three structures in the LUQ1) Stomach 2) Spleen 3) Pancreas (May be more)Name three structures in the RLQ1) Cecum 2) Appendix 3) Right ovary (females) (May be more)Name three structures in the LLQ1) Descending colon 2) Sigmoid colon 3) Left ovary (females) (May be more)After inspection, what is the first thing you have to do as part of your examination! (Hint: It is different from every other examination routine)Auscultation! Do the painful quadrant first!This type of abdomen is often seen in patients with severe weight loss and debilitating disease, almost indented.Scaphoid AbdomenIf there is a fixed dullness upon percussion, what are you suspecting?Mass or tumorTrue or False : The liver upon percussion is usually 6-12cm of dullness at the mid-clavicular line.TruePatient presents with a sickly appearance. Upon auscultation you hear slightly reduced bowel sounds in the right lower quadrant. During percussion the sound is a bit too tympanic, and when you palpate the area the patient has significant tenderness at McBurney's point. DDx?Acute AppendicitisWhat positive orthopedic test for acute appendicitis is where the doctor puts pressure in the LLQ and the patient feels pain in the RLQ.RovsingsWhat are two other special tests you can do for signs of acute appendicitis?Psoas stretch, obturator sign.Patient is a 40 year old female, who exhibits chronic cramping and abdominal pain/bloating upon eating meals. Also experiences this discomfort under times of stress and before her menstral cycle. DDx?Irritable Bowel SyndromePatient presents with insidious and chronic abdominal pain, experiences rectal bleeding with passing of stooles, has fatigue, weight loss, and ultimately a loss of appetite. Upon inspection, he has ulcers within his colon and rectum, and you also notice clubbing of the fingers. DDx?Ulcerative ColitisPatient presents with abdominal bloating, but has normal bowel sounds. Upon percussion you only hear normal resonance. Palpation you find diffuse abdominal tenderness over colon. Symptoms present are diarrhea, fever, and abdominal cramps. DDx?Crohns DiseasePatient presents with a guarded movement, they do not seem to want to move at all. Upon auscultation you hear friction rubs, and percussion sounds dull. Upon trying to palpate, there is substantial muscle guarding by the patient. DDx?PeritonitisPatient presents with a distention in their abdomen. YOu hear no bowel sounds, and percussion is hyper-tympanic. Upon palpation the patient has muscle guarding due to tenderness. DDx?Small intestine obstructionTrue or False : Hyperactive/loud sounds could be early indication of an early obstruction.TrueA patient presents with an obvious hernia. Upon having them bear down, the hernia disappears. What conclusion can be made about the location of the hernia?It is deep to the muscleName the three most common sites of hernias.Groin, umbilicus, and past scarsUpon auscultation of the patients RUQ you hear a venous hum indicating superficial collateral blood flow. What do you suspect?Enlarged LiverWhich sided heart failure is usually associated with an enlarged liver?Right-sided heart failureMurphy's inspiratory arrest sign is when the patient stops inspiring due to increasing pain as they breath in. The doctor can use a thumb/fingertip pressure under the rib cage to further invoke pain. What is this testing for?Gall BladderWhat are the five F's of Acute Cholecysitis?Female, Fertile(Pregnant), Forty, Fat, FlatulentThis is known as formation of calculi within the gallballder.CholelithiasisPatient presents experiencing sharp cramping pain in his RUQ lasting at least 30 minutes, and pain behind his right shoulder. Auscultation is normal. Percussion invokes pain when doing so over the right midclavicular line. Patient has a positive Murphy's Sign. DDx?Acute CholecystitsThis organ is very tympanic upon percussion, also known as hyper-resonant.Stomach, due to the magenblase.Condition where the cardiac sphincter allows stomach contents to reflux into the esophagus causing irritation.GERDPatient experiences heartburn and acid taste in his mouth at least twice a week, ddx?GERDCondition caused by breakdown in the lining of the stomach or duodenum. Can be caused by excessive alcohol, regular use of aspirin or other NSAIDs, and smoking.Peptic UlcerPatient presents with upper abdominal pain that wakes them at night, usually feels full but sometimes gets hungry 1-3 hours after eating. They also say they have had black tarry stools. DDx?Peptic UlcerTrue or False : A palpable spleen is often considered a red flag?TrueThe most common presentation of an enlarged spleen is due to what?MonoTrue or False : A ruptured spleen could be diagnosed by elevation of the left testicle?True, also known as Kerr's SignWhich kidney is usually more palpable?RightOrthopedic test of the kidney where a patient stands on their toes and suddenly drops weight to their heels as they strike the ground.Heel-Jar testThe most common kidney stones consist of what substance?Calcium oxylate or Calcium phosphateA 42 year old male walks into your office complaining of back pain that doesn't change with position and keeps him up. He also says he can feel it in his groin. Upon inspection you notice minimal swelling. Auscultation is hypoactive. There is palpatory tenderness over the costovertebral angle. DDx?Nephrolithiasis (kidney stones)True or False : An upper UTI extends from the urethra to the bladder.False, that is a lower UTIPatient walks into your office stating that they often have an urgency to pee, but it is painful when doing so. They also state they have seen blood in their urine when able to go. He has tenderness over his pubic area. DDx?UTIA 72 year old man with a history of smoking walks into your office complaining of severe abdominal and back pain. He often has nausea, sometimes vomiting, and experiences dizziness and syncope. Upon auscultation, you hear he has tachycardia. What are you suspecting?Abdominal Aortic AneurysmTrue or False : When too much blood flows through the veins, a "hum" can be heard?True