Abdominal Exam 2 Definitions PDF

Abdominal TERM DEFINITION viscera Internal organs, soft - Intestines, liver, kidneys peritoneum Layer of tissues that line the abdominal cavity and organs ascites Abnormal fluid build up in th...

Abdominal TERM DEFINITION viscera Internal organs, soft - Intestines, liver, kidneys peritoneum Layer of tissues that line the abdominal cavity and organs ascites Abnormal fluid build up in the space between the lining and organs keloids Type of raised scar resulting from excessive scar tissue growth hepatomegaly Enlarged liver splenomegaly Enlarged spleen CVA tenderness Costavertebral angles over the 12th rib Indication of: puelonephritis, renal calculi, or hydronephrosis AAA Abdominal aortic aneurysm - Enlargement of aorta that can lead to a life threatening rupture Peristalsis Involuntary contractions and relaxations of muscles in GI Wave-like to move food along GI tract Hernia Bulging of internal organ through a weakened area Anastomosis Surgical connection between two body structures - Bowl resection Fistula Abnormal opening or passage between two organs or to the surface of the body Ulcers Open sores Barrett’s Esophagus Condition where the esophageal tissue changes to the intestinal tissue due to stomach acid exposure Appendix Small, finger shaped structure in the colon C. DIFF Bacteria that causes diarrhea and colitis Candida Type of fungal infection caused by yeast - Oral thrush polyps An abnormal growth of cells that protrude from the surface constipation Decreased BM frequency or the passage of lumpy hard stool diarrhea Loose, watery stool IBS Irritable bowel syndrome IBD Inflammatory bowel disease diverticulitis Small, bulging pouches or sacs that form on the lining of the colon BRBPR Bright red blood per rectum hematochezia Passage of fresh blood per anus; usually in the stool Esophageal varices Enlarged or dilated submucosal veins in the esophagus GERD Gastroesophageal reflux disease hemorrhoids Swollen veins around the anus/rectum flatulence Passage of intestinal gas melena Black, tarry, sticky stool odynophagia Painful swallowing EGD Procedure of the upper GI tract, “upper endoscopy” colonoscopy Procedure of the lower GI tract proctitis Inflammation of the rectal lining tenesmus A persistent, painful urge to defecate without excreting stool colostomy Surgical opening of the colon to the abdomen borborygmus Gurgling, rumbling sound from abdomen feces The material in a bowel movement  indigestion Dyspepsia, or an upset stomach. Sensation of discomfort in abdomen Anal fissure Small tear in the thin, moist skin that lines the opening of the anus suppository Medication inserted into the rectum, vagina, or urethra Stoma Portion of bowel or ureter that is surgically openned and brought through abdominal wall Internal anatomy Viscera Soft internal organ solid Maintains shape; no air pockets - Liver - Spleen - Uterus hollow Can change shape - Stomach - Gallbladder - Colon - bladder Abdominal quadrants and regions R hypochondriac epigastric L hypochondriac R lumbar umbilical L lumbar R iliac/ inguinal hypogastric L iliac/ inguinal R upper quadrant L upper quadrant R lower quadrant L lower quadrant Referred Pain What does it mean when there is pain in the Referred pain from the pancreas or spleen left shoulder? What does it mean when there's pain in the Referred pain from the gallbladder right shoulder? What does it mean when there is right upper Gallbladder pain back? What does it mean when there is left upper Kidney pain back pain? Ureter pain What does it mean when there is midback Pancreas or kidney pain pain? What does it mean when there is low mid Rectal pain back pain? What does it mean when there is Epigastric Stomach pain pain? Duodenum pain Pancreas pain What does it mean when there is epigastric Gall bladder RUQ pain? Biliary tree liver What does it mean when there is umbilical Appendix pain pain? Small bowel Proximal colon What does it mean when there is left sided Flank pain from kidneys pain? Can radiate down abdomen from ureter What does it mean when there is suprapubic Rectum pain? Colon Uterus Bladder Prostate Abdominal tests What are the steps of abdominal 1. inspect assessment? 2. Auscultation 3. Percussion 4. Palpation Rebound tenderness Pressing down then releasing quickly - Shows signs of irritation of the peritoneum - Associated with appendicitis or peritonitis Fluid wave test Assess presence of fluid in the abdominal cavity - 1 hand on either side of stomach and press 1 then other - Assess “wave” Psoas sign Patient is laying on left side, hyperextend knee back Pain in RLQ Irritation of muscle associated with appendicitis Obturator sign Support patients right knee and ankle Flex hip and knee Rotate leg Pain in RLQ Irritation of obturator muscle associated with  appendicitis chloecystitis Inflammation of the gallbladder Pain in the RUQ Blumberg sign Rebound tenderness showing appendicities Rovsing sign Referred rebound (on other side) Acute appendicities Murphy sign Pain under liver Gallbladder pain Mcburneys point Right side upper pain Inflammation of appendicitis Asucultation of Abdomen Hyperactive BS Rapid mobility - Diarrhea Hypoactive BS Diminished mobility - After surgery or bowl obstruction Absnet BS May be an emergency! borborymus Gurgling or rumbling from abdomen Types of pain for Abdomen Visceral Localized intermittent pain parietal Localized at source, more severe and steady referred Away from primary site Musculoskeletal Compact bone Outer layer of bone Spongy bone Inside of bone osteoblasts Responsible for bone fomation, growth and healing of bones osteocytes Matures form of osteoblasts  Maintain bone tissue Axial skeleton Head and trunk Appendicular skeleton Extremities Shoulders hips Movements abduction away adduction toward circumduction around inversion in eversion out extension straightening hyperextension Over 180 degrees flexion bending dorsiflexion Toes up plantarflexion Toes down supination up protraction forward retraction backward Rotation Towards body or away from body internal/external Anatomy Skeletal voluntary Consciously controlled by nervous system Skeletal fibers are striated and attached to the bones - facilitating movement smooth Involuntary control Not striated In hollow organs - Peristalsis cardiac Involuntary control Are striated but are interconnected to each other to receive and continue electrical signals of the heart Types of joints fibrous Sutures between skull and bone Moveable cartilaginous Spinal vertebrae synovial Knee, hip, shoulder With fluid sac for ease of movement ligaments Bands of dense connective tissue that connect BONES TO JOINTS bursae Small fluid sacs between bone and soft tissue to cushion Temporomandibular joint Jaw bone Look for TMJ - clicking or popping Sternoclavicular joint Under clavicle Look for ROM Cervical, thoracic, and lumber spine The full length of the back Palpate for spinous processes and muscles STRAIGHT LEG TEST Tool: Goniometer Ratings 5 - active motion with resistance, normal 4- active motion with some resistance 3- active motion against gravity 2- passive ROM 1- slight contractions 0- no muscular contractions Abnormal spine findings Kyphosis Hunched back lordosis Pregnacy position Over arched lumbar scoliosis S shaped spine, curve(s) in spine laterally Flattening of lumber curvature Absence of normal curve in lumbar region Lumbar hyperlordosis Excessive inward curvature of the lumbar spine Ankylosing spondylitis Chronic inflammatory condition affecting spine and joints meeting the pelvis Abnormal hand findings Ulnar deviation Wrist movement where hand moves towards ulnar side (toward pinkies) - Rheumatoid arthritis ganglion Noncancerous lump filled with gelatinous fluid near joints or tendons of wrists and hands Herberden’s nodes Hard bony swellings that develop at joints closest to fingertips - Osteoarthritis Swan neck deformity Abnormal positioning of the fingerings Proximal are hyperextended and distal are flexed - Rheumatoid arthritis Hand osteoarthritis Degenerative joint disease that affects cartilage in joints leading to pain, stiffness, and loss of function Rheumatoid arthritis Autoimmune disease that causes chronic inflammation of joints leading to pain, swelling, and joint damage tenosynovitis Inflammation of tendons and surrounding sheath that causes pain, swelling, and difficulty moving Thenar atrophy Wasting away or weakening of muscles located at base of thumb Abnormalities of the foot Acute gouty arthritis Sudden and severe attack of pain, redness, and swelling in joint of big toe Accumulation of uric acid crystals in joint Caused by dietary factors, dehydration, or medications Hallux valgus Deformity of the big tow where it deviates towards other toes  Accompanied by bony lump at base of toe corn Thickened area of skin that developed in response to pressure or friction Hammer toe A deformity of the toe where the middle joint bends downward Plantar wart Small, hard growth on the sole of feet cause by a virus (human papillomavirus) osteoporosis Decreased bone density and increased fragility of bone Higher risk of fracture Triggers: aging, hormonal changes, low calcium diets TEST Carpal tunnel test WRISTS - Phalen test - Tinel sign test PHALEN TINEL - Hold wrists - Percuss over together with the median fingers nerve pointing - No tingles or downward numbness is - No tinglings a NEGATIVE or numbness TEST is a NEGATIVE TEST McMurrary test KNEES - Patient is supine - Hold foot and lift leg - Bed at knee - Hold knee steady and move foot lateral - PAIN? Bulge test KNEES - Differentiate between tissue swelling and small amounts of fluid - Press on either side of knee cap Ballottement test KNEES  - Detect larger amound of fluid - Milk fluid from top of the knee - Press into bottom of knee to feel for fluid Anatomic Snuff box test HANDS - Palate tissue between thumb and pointer finger to look for tenderness - Indication of wrist trama Squeeze test HANDS - Patient will squeeze hands - Test for strength and any pain in the metacarpals or phalangeal region Neurological Nervous system Coordination and regulation of body function - CNS - PNS CNS - Brain - Spinal cord What is the CNS covered by? meninges What are the 3 spaces of the CNS 1. Epidural 2. Subdural 3. Subarachnoid space What is the epidural space? Local anesthesia What is the subdural space? hematomas What is the subarachnoid space? hemorhages What does the CNS contain? Upper motor neurons that influence lower motor neurons (PNS) The Brain Located in the cranial cavity What are the 4 major divisions of the brain? 1. Cerebrum 2. Diencephalon 3. Brain stem 4. Cerebellum What is the cerebrum? The left and right hemispheres that communicate impulses from the opposite side of body What are the 4 lobes of each hemisphere? 1. Frontal 2. Temporal 3. Parietal 4. Occipital What does the frontal lobe do? Directs voluntary, skeletal actions Influences communication, emotions, intelligence, reasoning, judgment, behavior What does the temporal lobe do? Receives and interprets impulses from the ear What does the parietal lobe do? Interprets tactile sensations (pain, touch, temperature, shapes) What does the occipital lobe do? Influences ability to read with understanding and is the visual receptor center What is the diencephalon? Responsible for signaling What is in the diencephalon? 1. Thalamus 2. Hypothalamus What does the thalamus do? Screens and directs impulses to specific areas in the cerebral cortex What does the hypothalamus do? Regulates body functions such as - Water balance - Appetite - Vital signs - Sleep cycles - Pain perception - Emotional status Where is the brain stem located? In the cranial cavity What are the three parts of the brain stem? 1. Mid brain 2. Pons 3. Medulla oblongata What does the mid brain do? It is the relay center for reflexes from the ear and eyes Sends impulses between higher cerebral centers to the lower centers What does the pons do? Various reflex actions What does the medulla oblongata do? Contains nuclei for the cranial nerves Control center and regulation for  respiratory functions, HR, and BP What does the cerebellum do? Primary functions include coordination and smoothing of voluntary movements Maintains equilibrium and muscle tone Where is the spinal cord? Vertebral canal Extends from the medulla oblongata to the lumbar vertebrae (NOT ALL THE WAY DOWN TO SACRUM) What does the spinal cord do? Conducts - sensory impulses up to the brain - Motor impulses down to the neurons to stimulate glands/muscles Simple reflexes What are sensory impulses? Impulses that travel up to the brain by the ascending neural pathway What are the 2 ascending pathways? 1. Spinothalamic tract 2. Posterior column What is the spinothalamic tract? Sensations of pain, temperature, light (non-objective) touch What are the posterior columns? Sensations of position, vibration, and fine touch (more specific) What are motor impulses? Impulses that travel down from the brain via the descending neural pathway What are the 2 descending neural pathways? 1. Pyrimidal (corticospinal) tract 2. Extrapyramidal tract What is the pyrimidal tract? Impulses that are carried to the muscle to produce voluntary movements that involve skill and purpose What is the extrapyramidal tract? Conducts impulses to the muscles related to retaining/maintaining muscle tone and body control What is the PNS? Peripheral nervous system; carries information to and from the CNS What makes up the PNS? 12 pairs of cranial nerves 31 pairs of spinal nerves What are the two nerve fiber types? 1. Somatic 2. autonomic What is the somatic nervous system? Mediates conscious VOLUNTARY activities What is the autonomic nervous system? Mediates unconscious INVOLUNTARY activities Carry both cranial and spinal nerves from the CNS to the INVOLUNTARY muscles Maintain internal homostasis Incorporates the sympathetic and parasympathetic nervous systems What are the somatic fibers? Carry CNS impulses to the VOLUNTARY skeletal muscles What are the autonomic fibers? Carry CNS impulses to the smooth INVOLUNTARY muscles (heart, intestines, glands) What is the sympathetic nervous system? - STRESS - FIGHT OR FLIGHT - Elicits respons such as - Decreasing gastric secretions, brochiole dilation, increase HR, pupil dilation - In thoracolumbar level (T1 to L2) What is the parasympathetic nervous - RELAX system? - REST AND DIGEST - Restores and maintains normal body functions - Decreasing HR back to resting HR - In craniosacral regions (S1 to S2 and Cranial nerves 3, 6, 9, 10) How many cranial nerves from the brain or 12 pairs brain stem? What do they do? Transmit motor or sensory messages What is the mnemonic for the PNS cranial Some nerves? Say Marry Money But My Brother Says Big  Butts Matter More What does that mean for the nerve Sensory processes? Sensory Motor Motor Both Motor Both Sensory Both Both Money money What are the specific nerve names? 1. Olfactory 2. Optic 3. Oculomotor 4. Trochlear 5. Trigeminal 6. Abducens 7. Facial 8. Vestibulocochlear 9. Glossopharyngeal 10. Vagus 11. Accessory 12. Hypoglossal What is the mnemonic for the nerve names? 1. Oh 2. Oh 3. Oh 4. To 5. Touch 6. And 7. Feel 8. Very 9. Green 10. Vegetables 11. A 12. H How many pairs of spinal nerves? 31 pairs What are the spinal nerves? 8 cervical 12 thoracic 5 lumbar  5 sacral 1 coccygeal What do neurological checks include? Mental status Cranial nerves Motor and cerebellar systems Sensory systems Reflexes What does a mental status look at? Verifies validity of patients self report What are the screening tools for mental MoCA status? Mini-mental status exam - Tests memory Glasgow coma scale - Traumatic injury Alert and oriented x4 - Person, time, place, and situation What is done to check cranial nerves? CT Imaging