Abdominal Assessment Flashcards

Bowel Sounds

• Hypoactive Bowel Sounds: Occur infrequently with sounds heard after long intervals; normal range is 5 to 34 sounds per minute.
• Hyperactive Bowel Sounds: Also known as borborygmi, characterized by frequent sounds indicative of increased intestinal activity.
• Absent Bowel Sounds: No sound detected over a 3 to 5-minute period suggests potential abdominal pathology.

Abdominal Assessment Landmarks

• Four quadrants created by intersecting horizontal line through the umbilicus and vertical line via xiphoid process and symphysis pubis serve as key landmarks.

Steps for Abdominal Assessment

• Inspection: Observe abdominal contour, skin, and movements from various angles (eye level, foot of the bed, directly above). Use lighting to highlight subtle changes.
• Assessment Terms: Contours may be flat, rounded, protuberant, or scaphoid; assess for signs of ascites (indicated by protuberance and firmness).
• Auscultation: Should precede palpation/percussion to avoid altering bowel motility. Normal sounds are irregular tinkling/gurgling every 5 to 20 seconds.
  • Borborygmus: Reflects increased peristalsis; commonly noted before meals as "stomach growling," linked to factors like diarrhea or intestinal obstruction.
• Percussion: Helps locate non-palpable organs, identifies masses; tympanic sounds indicate air in intestines, dull sounds indicate solid organs like the spleen.
• Palpation: Conduct light palpation first to detect pain; deep palpation assesses any unusual masses or enlarged organs (e.g., liver). A relaxed abdomen is crucial for an accurate assessment.

Abdominal Quadrants

• Upper Right Quadrant: Contains liver, gallbladder, duodenum, head of pancreas, right adrenal gland, upper lobe of right kidney, ascending colon, and part of the transverse colon.
• Upper Left Quadrant: Includes left lobe of liver, majority of stomach, spleen, upper lobe of left kidney, pancreas, left adrenal gland, and segments of transverse and descending colon.
• Lower Right Quadrant: Houses the lower lobe of right kidney, cecum, appendix, ascending colon, right ovary, fallopian tube, ureter, spermatic cord, and possibly part of the uterus.
• Lower Left Quadrant: Consists of lower lobe of left kidney, sigmoid colon, descending colon, left ovary, fallopian tube, ureter, spermatic cord, and possibly part of the uterus if enlarged.

Auscultation Sounds

• Characterized by gurgling and swishing, indicating normal bowel activity and movement.