Abdominal Physical Examination ATI

Abdominal Physical Examination (ATI)

• Inspection: Assess for distention, scars, bruising, or other abnormalities
• Auscultation: Listen for bowel sounds and vascular sounds (e.g., bruits)
• Percussion: Assess for tympany and dullness to identify gas, fluid, or masses
• Palpation: First, perform light palpation to assess tenderness. Then, perform deeper palpation to identify masses or organ enlargement

Technique for Detecting Tenderness (ATI)

• Use light palpation to check for tenderness, then deepen palpation to check for masses.
• Avoid palpating painful areas first to prevent further pain.

Signs of Appendicitis (ATI)

• Classic signs: Right lower quadrant (RLQ) pain, rebound tenderness, and guarding
• Special tests:
  • McBurney's Point tenderness
  • Rovsing's sign (RLQ pain when palpating LLQ)
  • Psoas sign (pain with leg extension)
  • Obturator sign (pain with internal rotation)

Sounds Heard During Arterial Auscultation (ATI)

• Bruits: Abnormal, high-pitched sounds indicating turbulent blood flow, often due to narrowing of arteries (e.g., abdominal aortic aneurysm).

Organ Locations in Abdominal Quadrants (ATI)

• RUQ: Liver, gallbladder, duodenum, head of pancreas
• LUQ: Spleen, stomach, pancreas
• RLQ: Appendix, cecum, right ovary
• LLQ: Left ovary, sigmoid colon

Obturator Sign Technique (ATI)

• Flex the patient's right hip and knee, then internally rotate the hip. Pain in the RLQ suggests appendicitis.

Irritable Bowel Syndrome (IBS) (ATI)

• Symptoms: Abdominal pain or discomfort, bloating, diarrhea, and/or constipation.
• Symptoms often relieved by defecation.

Expected Findings for Abdominal Percussion (ATI)

• Tympany: Normal over the stomach and intestines (gas).
• Dullness: Over solid organs like the liver or spleen or fluid-filled areas like ascites.

Urinary Tract Infection (UTI) Signs (ATI)

• Painful urination (dysuria), increased frequency/urgency, cloudy or foul-smelling urine, lower abdominal pain, hematuria, fever, and chills.

Hepatitis A, B, and C Transmission and Symptoms (ATI)

• Hepatitis A: Fecal-oral transmission, jaundice, fatigue, nausea.
• Hepatitis B: Bloodborne, sexual contact, fatigue, jaundice, dark urine.
• Hepatitis C: Bloodborne, often asymptomatic until advanced liver disease (cirrhosis, liver cancer).

Differences Between Syphilis, Genital Herpes, Condylomata Acuminata, and Penile Carcinoma (ATI)

• Syphilis: Chancre (painless ulcer)
• Genital Herpes: Painful, fluid-filled blisters, recurrent outbreaks
• Condylomata Acuminata (genital warts): Caused by HPV, warty growths
• Penile carcinoma: Firm, ulcerated lesion, typically non-painful.

Breast Characteristics (ATI)

• Symmetry, contour, and any skin changes (e.g., dimpling or puckering).

Cancerous vs. Non-Cancerous Breast Masses (ATI)

• Cancerous: Hard, irregular shape, fixed to the tissue, non-tender.
• Non-cancerous: Smooth, mobile, tender, round or oval shape.

Palpation Techniques for Breast Examination (ATI)

• Use the pads of fingers, examine in a systematic pattern (circular, vertical, or radial).

Breast Cancer Risks (ATI)

• Family history, genetic mutations (e.g., BRCA1, BRCA2), age, personal history, hormonal therapy, alcohol use, obesity, lack of exercise.

Red Flags During Breast Examination (ATI)

• New or unusual masses, skin dimpling, nipple discharge (especially blood), changes in size or shape.

Rheumatoid Arthritis (ATI)

• Chronic inflammatory disorder affecting joints, especially in hands and feet. Causes pain, swelling, stiffness, and deformity.

Range of Motion Terms (ATI)

• Flexion: Decreasing the angle between body parts (e.g., bending the elbow)
• Extension: Increasing the angle between body parts (e.g., straightening the elbow)
• Abduction: Moving away from the body's midline
• Adduction: Moving toward the body's midline
• Inversion: Turning inward (e.g., turning the foot inward)
• Eversion: Turning outward (e.g., turning the foot outward)

Positive Tinels Sign (ATI)

• Tapping over the median nerve at the wrist causes tingling or pain in the fingers, indicating carpal tunnel syndrome.

Heberden's and Bouchard's Nodes (ATI)

• Heberden's nodes: Bony growths at the distal interphalangeal joints (DIP) in osteoarthritis.
• Bouchard's nodes: Bony growths at the proximal interphalangeal joints (PIP) in osteoarthritis.

Assessing Deep Tendon Reflexes (ATI)

• Use a reflex hammer, tap the tendon (e.g., patellar tendon), and observe for normal responses (e.g., knee jerk). Test reflexes at the biceps, triceps, patellar, and Achilles tendons.

Meningeal Irritation (ATI)

• Signs: Neck stiffness (nuchal rigidity), headache, fever, photophobia, positive Brudzinski and Kernig signs.

Decorticate vs. Decerebrate Postures (ATI)

• Decorticate: Flexion of arms and extension of legs (damage to corticospinal tract)
• Decerebrate: Extension of arms and legs (damage to brainstem)

Graphesthesia and Stereognosis (ATI)

• Graphesthesia: Ability to recognize numbers/letters on skin.
• Stereognosis: Ability to recognize objects by touch.

Identifying Signs and Symptoms of Stroke (ATI)

• Sudden numbness/weakness (especially one side), confusion, trouble speaking/understanding speech, trouble walking, dizziness

Different Types of Tremors (ATI)

• Resting tremor: Seen in Parkinson's disease, occurs when the body part is at rest.
• Action tremor: Occurs with voluntary movement, as in essential tremor.

Cauda Equina Syndrome (ATI)

• Serious condition: Lower spinal cord nerves are compressed causing severe back pain, sensory loss in lower extremities, and bowel/bladder dysfunction.

HPV Vaccine and Cervical Cancer

• The vaccine protects against HPV types 16 and 18, which are responsible for most cases of cervical cancer.

Risks of Prostate Cancer (ATI)

• Family history, age (risk increases after 50), African American ethnicity, high-fat diet, and sedentary lifestyle.

Torsion of the Spermatic Cord

• Emergency causing severe scrotal pain, swelling, and nausea, due to twisting of the spermatic cord.

Herpes Simplex 2 (ATI)

• Causes genital herpes with painful, recurrent outbreaks of blisters and sores.

Differences in Vaginitis Types (ATI)

• Trichomonas Vaginitis: Frothy, greenish-yellow discharge, dysuria.
• Candida Vaginitis: Thick, white discharge, itching.
• Atopic Vaginitis: Caused by allergies, leads to irritation and discharge.
• Bacterial Vaginosis: Thin, grayish discharge with a fishy odor.

Signs of Benign Prostatic Hyperplasia (BPH) (ATI)

• Difficulty starting urination, weak stream, frequent urination, nocturia, sensation of incomplete emptying.