10 Questions
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.
light
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.
rigidity
Rebound ______ is abdominal pain that occurs immediately after the removal of the examiner’s hand after depression of an abdominal area.
tenderness
Referred ______ or rebound- palpation of the lower left quadrant may produce tenderness and rebound tenderness in the right lower quadrant in appendicitis.
tenderness
Blumberg's sign is a clinical sign in which there is ______ upon removal of pressure rather than application of pressure to the abdomen.
pain
Guarding is a voluntary contraction of the ______ musculature to avoid pain.
abdominal wall
Light palpation can assess ______ integrity and identify masses.
muscle
Palpation of the abdomen can detect ______ such as lipomas or hernias.
irregularities
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
Learn about the process of auscultation of the abdomen, including proper positioning, stethoscope placement, and what to listen for in each quadrant. Test your knowledge on normal and abnormal bowel sounds and their clinical implications.
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