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Bates Chapter 11
Terms in this set (60)
What are the four abdominal quadrants?
RUQ, RLQ, LUQ, LLQ
What are the three sections of the abdomen going from chest to pelvis?
epigastric, umbilical, hypogastric (suprapubic)
Where is the costovertebral angle?
the lower border of the 12h rib and the transverse processes of the upper lumbar vertebrae
What are the three types of pain?
parietal, visceral, referred pain
this type of pain occurs when hollow abd organs contract unusually forcefully or are distended or stretched-- this pain can be difficult to localize-- can be described as gnawing, burning, cramping, or aching
this type of pain originates from inflammation-- it is a steady, aching pain that is severe. It is usually precisely localized and is typically aggravated by movement.
this type of pain is felt in distant sites, that are innervated at approximately the same spinal levels as the disordered structures-- this pain develops as the initial pain becomes more intense. This pain makes it seem as if the initial pain is radiating from the initial site.
chronic or recurrent discomfort or pain centered in the upper abdomen
the subjective negative feeling that is nonpainful-- includes: bloating, nausea, upper abdominal fullness and heartburn
pain with swallowing
this sx must be present for at least 12 weeks of the prior 6 months and will have associated conditions of: fewer than 3 BMs per week, 25% more defecations with either straining or sensation of incomplete evacuation, lumpy or hard stools; manual facilitation
a constant urge to defecate
no passage of either feces or gas
black, tarry stools
If you have melena, the blood is usually coming from the ___________ GI
if you have hematochezia, the blood is usually coming from the _____________ GI
stools that are red or maroon-colored
What causes jaundice/icterus?
increased levels of bilirubin
name the four types of urinary incontinence
stress, urge, over-flow, functional
this type of incontinence happens when increased abd pressure causes bladder pressure to exceed urethral resistance due to poor urethral sphincter tone or poor support of bladder neck
this type of incontinence happens when urgency is followed by immediate involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance
this type of incontinence happens when neurologic disorder or anatomic obstruction from pelvic organs or the prostate limits bladder emptying until the bladder is over-distended
this type of incontinence may arise from impaired cognition, musculoskeletal problems, or immobility
what are the possible contours of the abd?
flat, rounded, protuberant, scaphoid
voluntary contraction of the abdominal wall, often accompanied by a grimace that may diminish when pt is distracted
involuntary reflex contraction of the abd wall that persists over several examinations
If you press down on a pt's abd and it hurts when you release the pt has _____________
At what line do you measure the spin of the liver?
R midclavicular line
What is a normal liver span at the midclavicular line?
What is a normal liver span at the midsternal line?
What are the two ways to test for ascites?
test for shifting dullness, test for a fluid wave
What is Rovsing's sign
pain in the RLQ during left-sided pressure
What sign is this: Place your hand above pt's R knee, ask pt to raise R thigh against your hand (or ask pt to turn onto L side, then extend pt's R leg at the hip)
What sign is this: flex the pt's R thigh at the hip, with knee bent, and rotate the leg internally at the hip
What sign is this: hook your L thumb or the fingers of your R hand under the costal margin at the point where the lateral border of the rectus muscle intersects with the costal margin-- ask pt to take deep breath-- pt with this sign will experience a sharp increase in tenderness with a sudden stop in inspiratory effort
What is Murphy's sign indicative of?
What are Rovsing's sign, psoas sign, and obturator sign indicative of?
Where does parietal pain originate from?
inflammation in the parietal peritoneum
pain that started in the last 6-12 hours is:
pain that has been going on for the last 2-3 months is
bluish color at the umbilicus is indicative of what sign
Cullen's sign (bleeding in peritoneum)
bruising on the abd and flanks, esp. L side could be indicative of; What sign is this?
hemorrhagic pancreatitis; Grey's Turner sign
Appearance of distended and engorged umbilical veins which are seen radiating from the umbilicus across the abdomen to join systemic veins
Caput Medusa is a sign of severe __________
Hernia caused by separation of the rectus abdominis muscles
what is the most common type of hernia?
this hernia penetrates the inguinal triangle and creates a bulge superior and medial to the inguinal ligament
direct inguinal hernia
this hernia passes through the inguinal canal and creates a bulge over the inguinal ligament as it passes through the inguinal ring. In men it often herniates into the scrotum
indirect inguinal hernia
what are the 6 F's that can cause diffuse abdominal distension
fat, fluid, flatus, feces, fetus, fatal cancer
loud easily audible sound transmitted across the abdomen so it is not necessary to listen at multiple places, commonly called "growling."
what are the causes of absent bowel sounds?
perforation, infection, infarction, ischemia
what are the causes of decreased bowel sounds?
infection or injury
what are high pitched bowel sounds a sign of?
hollow sounds, which are normally present over most of the abdomen in the supine position, caused from bowel gas
a flat sound without echoes which can be a solid organ, a mass, areas of fluid, or large amount of stool
where is Traube's space?
L 6th rib, L costal margin, L midaxillary line
Presentation includes abdominal pain typically severe and located to the LUQ that may radiate to left upper back, nausea and vomiting, fever , and rapid pulse
feel like appendicitis, except general pain located in LLQ instead of RLQ, pain is sudden and severe, may also have fever, nausea, constipation, diarrhea
Presentation includes localized or diffuse RUQ pain that may radiate to right scapula, vomiting and constipation, low grade fever
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