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Questions and Answers
What is the correct order of assessment for an abdominal physical examination?
What is the correct order of assessment for an abdominal physical examination?
What is the purpose of light palpation during an abdominal examination?
What is the purpose of light palpation during an abdominal examination?
What does decerebrate posture indicate?
What does decerebrate posture indicate?
Which of the following signs is NOT associated with meningeal irritation?
Which of the following signs is NOT associated with meningeal irritation?
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Which of the following is NOT a classic sign of appendicitis?
Which of the following is NOT a classic sign of appendicitis?
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What sound is indicative of turbulent blood flow when auscultating arteries?
What sound is indicative of turbulent blood flow when auscultating arteries?
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Which symptom is associated with a stroke?
Which symptom is associated with a stroke?
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In which abdominal quadrant would you find the spleen?
In which abdominal quadrant would you find the spleen?
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What type of tremor occurs during voluntary movement?
What type of tremor occurs during voluntary movement?
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What does the obturator sign indicate when pain is elicited in the right lower quadrant?
What does the obturator sign indicate when pain is elicited in the right lower quadrant?
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What is a common symptom of Cauda Equina Syndrome?
What is a common symptom of Cauda Equina Syndrome?
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Which symptom is commonly associated with Irritable Bowel Syndrome?
Which symptom is commonly associated with Irritable Bowel Syndrome?
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Which HPV types are primarily targeted by the HPV vaccine to prevent cervical cancer?
Which HPV types are primarily targeted by the HPV vaccine to prevent cervical cancer?
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Which symptom is NOT typically associated with a Urinary Tract Infection?
Which symptom is NOT typically associated with a Urinary Tract Infection?
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Which type of vaginitis is characterized by a frothy, greenish-yellow discharge?
Which type of vaginitis is characterized by a frothy, greenish-yellow discharge?
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What is the typical presentation of Herpes Simplex 2 infection?
What is the typical presentation of Herpes Simplex 2 infection?
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Which characteristic is associated with a cancerous breast mass?
Which characteristic is associated with a cancerous breast mass?
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What symptom is associated with genital herpes?
What symptom is associated with genital herpes?
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What is the purpose of assessing symmetry during a breast examination?
What is the purpose of assessing symmetry during a breast examination?
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What does a positive Tinel's sign indicate?
What does a positive Tinel's sign indicate?
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Which of the following is a non-cancerous breast mass characteristic?
Which of the following is a non-cancerous breast mass characteristic?
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Which term describes moving a limb away from the body's midline?
Which term describes moving a limb away from the body's midline?
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What is the significance of observing for new nipple discharge during a breast examination?
What is the significance of observing for new nipple discharge during a breast examination?
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Which of the following is a risk factor for breast cancer?
Which of the following is a risk factor for breast cancer?
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Study Notes
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.
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Description
This quiz covers key techniques for performing an abdominal physical examination, including inspection, auscultation, percussion, and palpation. Additionally, it highlights signs of appendicitis and sounds heard during arterial auscultation. Perfect for nursing students seeking to enhance their clinical assessment skills.
