Podcast
Questions and Answers
Patients with ______ pain are asked to point the area of discomfort so that palpation of that area can be performed last.
Patients with ______ pain are asked to point the area of discomfort so that palpation of that area can be performed last.
abdominal
Begin with ______ palpation, using the fingertips of one hand to examine the patient’s abdominal wall.
Begin with ______ palpation, using the fingertips of one hand to examine the patient’s abdominal wall.
light
Light palpation can detect ______ distention and any irregularities of the abdominal wall.
Light palpation can detect ______ distention and any irregularities of the abdominal wall.
bladder
Spasm or ______ is the involuntary tightening of the abdominal musculature that occurs due to inflammation of underlying abdominal structures.
Spasm or ______ is the involuntary tightening of the abdominal musculature that occurs due to inflammation of underlying abdominal structures.
Rebound ______ is abdominal pain that occurs immediately after the removal of the examiner’s hand after depression of an abdominal area.
Rebound ______ is abdominal pain that occurs immediately after the removal of the examiner’s hand after depression of an abdominal area.
Referred ______ or rebound- palpation of the lower left quadrant may produce tenderness and rebound tenderness in the right lower quadrant in appendicitis.
Referred ______ or rebound- palpation of the lower left quadrant may produce tenderness and rebound tenderness in the right lower quadrant in appendicitis.
Blumberg's sign is a clinical sign in which there is ______ upon removal of pressure rather than application of pressure to the abdomen.
Blumberg's sign is a clinical sign in which there is ______ upon removal of pressure rather than application of pressure to the abdomen.
Guarding is a voluntary contraction of the ______ musculature to avoid pain.
Guarding is a voluntary contraction of the ______ musculature to avoid pain.
Light palpation can assess ______ integrity and identify masses.
Light palpation can assess ______ integrity and identify masses.
Palpation of the abdomen can detect ______ such as lipomas or hernias.
Palpation of the abdomen can detect ______ such as lipomas or hernias.
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Study Notes
Auscultation of the Abdomen
- Auscultation is performed to detect bowel sounds, rubs, or vascular bruits in the abdomen
- Normal bowel sounds are soft, gurgling, and irregular, occurring every 2-5 seconds
- Bowel sounds can be normal, audible, absent, hypoactive, hyperactive, or distant
Abnormal Findings
- Absent bowel sounds: bowel obstruction or paralytic ileus
- Hypoactive bowel sounds: decreased motility, post-surgery manipulation, inflammation, paralytic ileus, or late bowel obstruction
- Hyperactive bowel sounds (borborygmi): overstimulated or increased motility due to diarrhea, inflammation, laxative use, bleeding, or anxiety
- Abdominal bruits: "swooshing" sounds heard over major arteries due to stenosis or narrowing of vessels
Abdominal Inspection
- Normal findings: flat, concave, or convex abdomen, symmetric and without masses
- Abnormal findings: symmetric swelling (distention) due to intestinal gas, excess fluid, or tumor
- Distended abdomen: skin appears stretched and shiny, sides bulge depending on cause
Abdominal Inspection (continued)
- Bladder is not visible on inspection
- Palpable large, firm area in lower abdomen: distended bladder
- Neurogenic bladder: impaired nerve innervation, causing flaccid and distended bladder, partial emptying, and continual dribbling of urine
Palpation of the Abdomen
- Ask patients to point to the area of discomfort and palpate that area last
- Palpate each quadrant systematically, starting with light palpation
- Light palpation detects bladder distention, irregularities, tenderness, and masses
- Identify spasm or rigidity, guarding, rebound tenderness, and referred tenderness
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