Anatomy
These are two major organs in the RUQ
liver, head of the pancreas, gall bladder, duodenum, R kidney, some ascending and transverse colon
The location of McBurney's point
2/3 of the way from the umbilicus to the R superior iliac crest
Auscultation: 20 high pitched, gurgling sounds to the RLQ
nl. (not necessary to count or listen to all four quadrants)
Infection causes this to happen to bowel sounds
hypoactive or absent
Normal or abnormal: it's easier to palpate the liver and kidneys in a geriatric pt
Normal. Explain.
This is one organ of interest in the RLQ when rebound tenderness is (+)
appendix. also cecal valve, R ovary, ureter
The order of abd assessment
inspect, auscultation, percuss, palpate light then deep
Percussion: tympany
Normal. The abnormal findings, similar to the lungs, are dullness (fluid, an organ or a mass), or hyperresonance (gas)
Severe abd pain 2-4 hours after eating a fatty meal with (+) Murphy's sign are associated with disease of this organ
GB. eg cholecystitis
liver. smaller liver, less metabolism, higher risk of accumulation of drugs at toxic doses
This is the location a pt reports pain with (+) Blumberg sign
Use this assessment to differentiate gas from fluid when asssessing abd distension
fluid wave test
Inspection: rigid abdomen
Abnormal. When? What are the shapes? flat, scaphoid, rounded, protuberant
Avoid palpating this prominent abd pulsation
abdominal aortic aneurysm
One subjective complaint or objective finding common in pregnancy r/t the GI tract
gingival hyperplasia/bleeding, dyspepsia, hemorrhoids
These are the quadrants in which to auscultate the renal arteries
Use the bell on the abdomen to auscultate for this abnormality
bruit
Palpation: nodular liver border
abnl. Indicative of?
Bleeding, ascites, and mental status chagnges are associated with disease of this organ
liver.
Emergent finding in peds presenting with sudden onset fussiness, poor feeding, and currant jelly stool
intussusception
These are two organs in the LUQ
stomach (also epigastric), spleen, L liver lobe, body of pancreas, L kidney
A helpful technique during palpation when a pt is supine to enhance muscle relaxation
bend the knees, deep breathing, conversation such as hx gathering as a distraction
Palpation: spleen is palpable in a healthy person
abnl
Epigastric pain radiating to the back, anorexia, weight loss, oily stools are associated with disease in this organ
pancreas
This condition in newborns presents as projectile vomiting, watery or absent stool
pyloric stenosis. pyloric sphincter regulates food passage into the SI