# Abdomen - Exam 3

Term
1 / 43
The nurse is percussing the seventh right intercostal space at the midclavicular line over the liver. Which sound should the nurse expect to hear?
Click the card to flip 👆
Terms in this set (43)
Dullness

Abdominal percussion is performed to assess the relative density of abdominal contents, locate organs, and screen for abnormal fluid or masses in the abdomen. The liver is a solid organ which is located in the right upper quadrant and would elicit a dull percussion note. Tympany is heard over air-filled organs such as the stomach and intestines. It is the predominant sound that should be heard over the intestines, because air in the intestines rises to the surface when the person is supine. Resonance is a low-pitched, clear, hollow sound that predominates in healthy lung tissue. Hyperresonance is a lower-pitched, booming sound found when too much air is present such as with gaseous distension of the intestines in the abdomen or emphysema in the lungs.
Percuss and palpate the midline area above the suprapubic bone

The bladder is located in the suprapubic area (above the pubic bone) and if distended would elicit a dull sound when percussed and feel firm to palpation. However, this technique has been found to be unreliable and bedside bladder scanning with ultrasound is commonly used to estimate the bladder volume.
Protuberant

A bulging and stretched abdomen is described as protuberant. A protuberant abdomen is rounded, bulging, and stretched. A scaphoid abdomen caves inward. An obese abdomen appears uniformly rounded with a sunken umbilicus. A hernia is a protrusion of the abdominal viscera through an abnormal opening in the abdominal muscle wall.
Normal abdominal aortic pulsations

Pulsations from the aorta are normally observed beneath the skin in the epigastric area, particularly in thin people who have good muscle wall relaxation. Pulsations of the renal arteries are not visible. The vena cava is a vein, not an artery, and does not have pulsations. Waves of peristalsis are sometimes visible in very thin people and appear as a slow ripple moving obliquely across the abdomen.
Peritonitis

Diminished or absent bowel sounds signal decreased gastrointestinal motility which can be caused from inflammation from peritonitis, a paralytic ileus after abdominal surgery, or with a bowel obstruction. Diarrhea, laxative use, and gastroenteritis cause hyperactive, not hypoactive, bowel sounds.