Abdominal Anatomy & Landmarks
Where is the spleen located?
The left upper quadrant
What’s the first physical assessment step for the abdomen after inspection?
Auscultation.
Tympany on percussion in the umbilical region is considered(Not normal or normal?)
Normal
What sign is used to assess for gallbladder inflammation (cholecystitis)?
Murphy’s sign (pain on inspiration when palpating liver border).
In older adults, gastric acid secretion tends to increase/decrease
Decrease.
Which organ is primarily found in the right upper quadrant and produces bile?
The liver.
Why do we auscultate before palpation and percussion when assessing the abdomen?
Because palpation and percussion can increase bowel sounds, giving a false reading.
A “scaphoid” abdominal contour is described as ___ (concave/convex/flat?).
Concave (sunken in).
What condition does a positive fluid-wave test suggest?
Ascites (free fluid in the abdomen).
True or False: The liver size increases with aging.
False — it decreases in size.
Describe the location of the aorta in relation to the abdomen.
It runs down the midline, just left of the midline in the upper abdomen.
What percussion note predominates in a normal abdominal quadrant and why?
Tympany, high pitched, due to air in the intestines.
What might diminished or absent bowel sounds signal?
Decreased motility, possible peritonitis, paralytic ileus, or late bowel obstruction.
When suspecting appendicitis, you might test for the ___ sign (or the ___ muscle test).
Iliopsoas sign (or obturator test).
In a patient with chronic emphysema, why might the liver span appear lower on percussion?
The diaphragm is pushed downward by hyperinflated lungs.
Name the tissue that forms a double envelope supporting and stabilizing the abdominal organs.
The mesentery.
When deep palpating the abdomen, what are you assessing (list at least three things)?
Organ size, location, tenderness, masses, and abnormal enlargement.
An enlarged spleen should be palpated? True/False?
False, should Not be palpated—it may rupture easily; report to provider.
In a newborn, what sign (mass, vomiting, peristaltic waves) suggests pyloric stenosis?
Projectile vomiting, palpable olive-shaped mass, visible peristalsis.
What contour change might you see in an infant with an umbilical hernia?
A bulging or protruding navel, especially when crying.
Which quadrant is the appendix located in?
Right lower quadrant (RLQ).
What percussion finding might you expect with a large amount of ascites and why?
Dullness over fluid-filled areas because fluid replaces air.
A bruit heard in the upper abdomen just left of midline might indicate what serious condition?
An abdominal aortic aneurysm.
What is the significance of listening for at least 5 minutes when you cannot hear any bowel sounds?
To confirm true absence (ileus or bowel obstruction).
Why might an older adult with an acute abdominal condition show less abdominal rigidity than a younger adult?
Decreased abdominal muscle tone and less pronounced inflammatory response with age.