Cecum

• Ileal contents empty into cecum via ileocecal valve and appendix extends from base of cecum

Ascending Colon

• Rises from the cecum along the right posterior abdominal wall to the undersurface of the liver, where it turns toward midline (hepatic flexure)

Transverse Colon

• Crosses abdomen toward spleen, turning downward at splenic flexure

Descending Colon

• Continues along the left abdominal wall to rim of pelvis, where it turns medially and inferiorly to form sigmoid colon

Rectum

• Extends from sigmoid colon to the pelvic floor to the anal canal, terminating at the anus

Anus

• Where poopy leaves

• Your 6 pack, or 4 pack, or 2 pack
• Anteriorly

• GI tract continues to develop after birth until 2-3 yrs of age
• Liver is very large at birth
• Spleen is active in blood formation during first year of birth
• Kidney growth increases incrementally after birth

• Abdominal wall muscles stretch and lose tone
• Organs are displaced and affect functions
• Heartburn
• Gallstones
• Urinary stasis or urgency
• Constipation or flatus
• Hemorrhoids

• GI tract motility slows, secretion and absorption slows, and digestion overall decreases
• Food tolerance diminishes
• Diminished ability of liver to metabolize certain drugs
• Delayed gastric emptying
• Gallstones caused by increase in biliary lipids

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Regions of the Abdomen:  Name position 1

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Regions of the Abdomen:  Name position 2

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Regions of the Abdomen:  Name position 3

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Regions of the Abdomen:  Name position 4

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Regions of the Abdomen:  Name position 5

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Regions of the Abdomen:  Name position 6

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Regions of the Abdomen:  Name position 7

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Regions of the Abdomen:  Name position 8

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Regions of the Abdomen:  Name position 9

• Ovarian tumor
• Uterine fibroids
• Pregnancy
• Distended bladder

• Carcinoma
• Pancreatic cyst
• Gastric dilation

• Hernia
• Tumor
• Cysts
• Bowel obstruction

• Sounds of turbulent flow rushing past an obstruction
• Can be heard in aortic, renal, iliac, and femoral arteries

• High pitched sounds in association with respiration
• Indication of inflammation of peritoneal surface from tumor, infection, infarct
• May be heard over spleen and liver

• Soft, low-pitched, continuous sounds
• Can be heard over epigastric region and around umbilicus

• Initial: Preumbilical or Epigastric
• May become localized to RLQ

• Guarding
• Tenderness
• Anorexia
• Nausea or vomiting after pain onset
• Low-grade fever

• Intense
• Flank, extending to groin and genitals
• May be episodic

• Fever
• Hematuria

• Severe
• Unrelenting RUQ or epigastric pain
• May be referred to right subscapular area

• RUQ tenderness and rigidity
• Palpable gallbladder
• Anorexia
• Vomiting
• Fever

• Dramatic, sudden, excruciating LUQ, epigastric, or umbilical pain
• Present in one or both flanks
• May be referred to left shoulder

• Epigastric tenderness
• Vomiting
• Fever
• Shock

• Epigastric
• Radiating down left side of abdomen especially after eating
• May be referred to back

• Flatulence
• Borborygmi
• Diarrhea
• Dysuria
• Tenderness on palpation

• Hypogastric tenderness
• Symptoms of pregnancy
• Spotting
• Irregular menses
• Soft abdominal wall
• Mass on bimanual pelvic exam
• Rupture: shock, rigid abdominal wall, distention

• Lower quadrant
• Referred to shoulder
• With rupture is agonizing

• Intense
• LUQ, radiating to left shoulder
• May worsen with foot of bed elevated

• Shock
• Pallor
• Lower temperature

• Hypogastric
• Crampy, variable, infrequent, associated with bowel function

• Negative physical exam
• Pain with gas, bloating, distension
• Relief with passage of flatus or feces

• Crampy pain after ingesting dairy products

• Associated diarrhea
• Negative physical exam

• Abdominal tenderness
• Fever

• Colicky or dull and steady pain that does not progress or worsen

• Fecal mass palpable
• Stool in rectum

• Pain related to menses, intercourse

• Localized pain that increases with exertion or lifting

• Burning, gnawing pain in mid-epigastrum
• Worsens with recumbency

• + Nausea, vomiting, diarrhea
• Fever
• Physical exam negative

• Bowel sounds
• Friction rubs over liver and spleen

• Venous hums in epigastric area and around umbilicus
• Bruits over aorta, renal, and femoral arteries