Term
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Definition
| is a large oval cavity extending from diaphragm down to brim of pelvis |
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Term
| What are internal organs called inside the abdominal cavity? |
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Definition
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Term
| What is the solid viscera? |
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Definition
| those that maintain a characteristic shape: liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus |
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Term
| What fills most of the RUQ? |
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Definition
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Term
| What is normally palpable? |
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Definition
| Lower edge of liver and right kidney |
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Term
| What is the hollow viscera? |
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Definition
| stomach, gallbladder, small intestine, colon, and bladder depends on contents |
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Term
| What quadrant is the Small intestine located in? |
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Definition
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Term
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Definition
| is soft mass of lymphatic tissue on posterolateral wall of abdominal cavity, immediately under diaphragm |
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Term
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Definition
Lies obliquely with its long axis behind and parallel to tenth rib, lateral to midaxillary line
Width extends from ninth to eleventh rib, about 7 cm |
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Term
| Where is the descending aorta? |
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Definition
just to left of midline in upper part of abdomen
Descends behind peritoneum, and at 2 cm below umbilicus it bifurcates into right and left common iliac arteries opposite fourth lumbar vertebra |
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Term
| What do the R/L iliac arteries branch to become? |
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Definition
| Right and left iliac arteries become femoral arteries in groin area |
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Term
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Definition
Pancreas is a soft, lobulated gland located behind stomach
Stretches obliquely across posterior abdominal wall to left upper quadrant |
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Term
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Definition
| Bean-shaped kidneys are retroperitoneal, or posterior to abdominal contents |
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Term
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Definition
Liver
Gallbladder
Duodenum
Head of pancreas
Right kidney and adrenal gland
Hepatic flexure of colon
Part of ascending and transverse colon |
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Term
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Definition
Stomach
Spleen
Left lobe of liver
Body of pancreas
Left kidney and adrenal gland
Splenic flexure of colon
Part of transverse and descending colon |
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Term
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Definition
Cecum
Appendix
Right ovary and tube
Right ureter
Right spermatic cord |
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Term
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Definition
Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord |
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Term
| What is located in the midline? |
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Definition
Aorta
Uterus, if enlarged
Bladder, if distended |
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Term
| What is a developmental difference in infants/children? |
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Definition
| , umbilical cord shows prominently on abdomen |
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Term
| What is a developmental difference in pregnant women? |
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Definition
Nausea and vomiting, or “morning sickness,” is early sign of pregnancy for most pregnant women, starting between first and second missed periods
Another symptom is “acid indigestion” or heartburn (pyrosis) caused by esophageal reflux
Gastrointestinal motility decreases, which prolongs gastric emptying time
Decreased motility causes more water to be reabsorbed from colon, which leads to constipation -> hemorrhoids
Appendix displaced upward and to right |
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Term
| What is a developmental difference in aging adults? |
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Definition
-Fat accumulation
-Changes of aging occur in gastrointestinal system but do not significantly affect function when no disease is present
-Salivation decreases, causing a dry mouth and a decreased sense of taste
-Esophageal emptying is delayed; if an aging person is fed in supine position, this increases risk of aspiration
-Gastric acid secretion decreases with aging
-Incidence of gallstones increases with age,
-constipation |
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Term
| What are the common causes of constipation? |
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Definition
Decreased physical activity
Inadequate intake of water
Low-fiber diet
Side effects of medications
Irritable bowel syndrome
Bowel obstruction
Hypothyroidism
Inadequate toilet facilities, i.e., difficulty ambulating to toilet may cause person to deliberately retain stool until it becomes hard and difficult to pass |
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Term
| What subjective data is included in the abdominal examination? |
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Definition
Appetite
Dysphagia
Food intolerance
Abdominal pain
Nausea and vomiting
Bowel habits
Abdominal history
Medications |
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Term
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Definition
| Any difficulty swallowing? When did you first notice this? |
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Term
| What additional questions you should ask of infants/children? |
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Definition
Are you breastfeeding or bottle-feeding your infant? If bottle-feeding, how does infant tolerate formula?
How does infant tolerate new foods?
How often does your toddler/child eat? Does he or she eat regular meals? How do you feel about your child’s eating problems? Does your child have constipation? If so, for how long?
What are number of stools per day? Stools per week?
How much water and juice is in child’s diet?
Does the constipation seem to be associated with toilet training?
What have you tried to treat constipation?
Does child have abdominal pain? Please describe what you have noticed and when it started. For overweight child: How long has weight been a problem? |
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Term
| What additional questions should you of adolescents? |
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Definition
What do you eat at regular meals? Do you eat breakfast? What do you eat for snacks?
How many calories do you consume?
What is your exercise pattern?
If weight is less than body requirements: How much have you lost? By diet, exercise, or other means?
How do you feel? Tired, hungry? How do you think your body looks?
What is your activity pattern?
Is weight loss associated with any other body change, such as menstrual irregularity?
What do your parents and friends say about your eating? |
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Term
| What additional questions should you ask of aging adults? |
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Definition
How do you acquire your groceries and prepare your meals?
Do you eat alone or do you share meals with others?
Please tell me all that you had to eat yesterday, starting with breakfast.
Do you have any trouble swallowing these foods?
What do you do right after eating, such as walking or taking a nap?
How often do your bowels move? |
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Term
| During a physical examination of the stomach, should the muscles be contracted or relaxed? |
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Definition
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Term
| What are you inspecting the abdomen for? |
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Definition
-Contour
-Symmetry
-Umbiilcus
-Skin
-Pulsation/Movement
-Hair distribution
-Demeanor |
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Term
| What are the 4 types of stomach contour? |
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Definition
-Flat
-Scaphoid
-Rounded
-Protrudent |
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Term
| What are you ausculatating the abdomen for? |
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Definition
| Bowel sounds and vascular sounds |
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Term
| Why do you ausculatate first? |
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Definition
| This is done because percussion and palpation can increase peristalsis, which would give a false interpretation of bowel sounds |
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Term
| What side of the stethoscope do you use to listen to bowel sounds? |
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Definition
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Term
| Where do you start ausculatting/ |
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Definition
| Begin in RLQ at ileocecal valve area because bowel sounds are normally always present here |
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Term
| What are the characteristics of bowel sounds? |
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Definition
| Bowel sounds are high pitched, gurgling, cascading sounds, occurring irregularly anywhere from 5 to 30 times per minute; |
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Term
| What are the 3 classifications of bowel sounds? |
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Definition
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Term
| Can you usually hear brutis or vascular sounds? |
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Definition
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Term
| What do you usually percuss in the abdomen? |
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Definition
| general tympany, liver, and splenic dullness |
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Term
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Definition
First, percuss lightly in all four quadrants to determine prevailing amount of tympany and dullness
Move clockwise; tympany should predominate because air in intestines rises to surface when person is supine |
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Term
| What is the scratch test? |
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Definition
Place your stethoscope over liver
With one fingernail, scratch short strokes over abdomen, starting in RLQ and moving progressively up toward liver
When scratching sound in your stethoscope becomes magnified, you will have crossed border from over a hollow organ to a solid one |
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Term
| What is splenic dullness? |
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Definition
percussing for a dull note from 9th to 11th intercostal space just behind left midaxillary line
Tympany should result; ask person to take a deep breath; normally tympany remains through full inspiration |
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Term
| What is Costovertebral angle tenderness? |
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Definition
Indirect fist percussion causes tissues to vibrate instead of producing a sound
To assess kidney, place one hand over 12th rib at costovertebral angle on back
Thump that hand with ulnar edge of your other fist
Person normally feels thud but no pain |
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Term
| What is a fluid wave test indicative of? |
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Definition
| ascites (free fluid in the peritoneal cavity) because of distended abdomen, bulging flanks, and an umbilicus that is protruding and displaced downward |
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Term
| Should you begin with light or deep palpation? |
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Definition
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Term
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Definition
Begin with light palpation
With first four fingers close together, depress skin about 1 cm
Make gentle rotary motion, sliding fingers and skin together
Then lift fingers (do not drag them) and move clockwise to next location around abdomen |
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Term
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Definition
same technique described earlier, but push down about 5 to 8 cm (2 to 3 inches)
Moving clockwise, explore entire abdomen |
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Term
| How do you palpate obese people? |
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Definition
use a bimanual technique
Place your two hands on top of each other
Top hand does pushing; bottom hand relaxed and can concentrate on sense of palpation |
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Term
| What are you palpating the abdomen for? |
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Definition
| location, size, consistency, and mobility of any palpable organs and presence of any abnormal enlargement, tenderness, or masses |
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Term
| What's documented after palpating? |
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Definition
Location
Size
Shape
Consistency: soft, firm, hard
Surface: smooth, nodular
Mobility, including movement with respirations
Pulsatility
Tenderness |
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Term
| Where can you feel the liver? |
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Definition
Place your left hand under person’s back parallel to 11th and 12th ribs and lift up to support abdominal contents
Place your right hand on RUQ, with fingers parallel to midline |
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Term
| What is the hooking technique? |
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Definition
Hook your fingers over costal margin from above
Ask person to take a deep breath
Try to feel liver edge bump your fingertips |
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Term
| Where can you feel the spleen if enlarged? |
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Definition
To search for it, reach your left hand over abdomen and behind left side at the 11th and 12th ribs
Lift up for support; place your right hand obliquely on LUQ with fingers pointing toward left axilla and just inferior to rib margin |
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Term
| Where/how do you feel the kidneys? |
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Definition
Search for right kidney by placing your hands together in a “duck-bill” position at person’s right flank
Press your two hands together firmly (you need deeper palpation than that used with the liver or spleen) and ask person to take deep breath |
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Term
| Where does the L kidney sit in comparison to the R? |
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Definition
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Term
| What developmental considerations should be made for for infants/children? |
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Definition
Contour of abdomen is protuberant because of immature abdominal musculature
Skin contains a fine, superficial venous pattern; this may be visible in lightly pigmented children up to puberty
Inspect umbilical cord throughout neonatal period
At birth, it is white and contains two umbilical arteries and one vein surrounded by mucoid connective tissue, called Wharton jelly
Umbilical stump dries within a week, hardens, and falls off by 10 to 14 days; skin covers area by 3 to 4 weeks
Abdomen should be symmetric, although two bulges common
May note an umbilical hernia; appears at 2 to 3 weeks and especially prominent when infant cries
Reaches maximum size at 1 month (up to 2.5 cm or 1 inch) and usually disappears by 1 year
Another common variation is diastasis recti, a separation of rectus muscles with a visible bulge along midline
Condition more common with black infants, and it usually disappears by early childhood |
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Term
| What shows respiratory movement in an infant? |
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Definition
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Term
| When percussing an infant, what do you find? |
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Definition
Percussion finds tympany over stomach (the infant swallows some air with feeding) and dullness over liver
Percussing the spleen is not done
Abdomen sounds tympanitic, although it is normal to percuss dullness over bladder; dullness may extend up to umbilicus |
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Term
| When palpating an infant, what do you find? |
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Definition
Normally, you may palpate spleen tip and both kidneys and bladder
Also easily palpated are cecum in RLQ, and sigmoid colon, which feels like a sausage in left inguinal area
Make note of newborn’s first stool, a sticky, greenish-black meconium stool within 24 hours of birth |
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Term
| When inspecting a child, what do you find? |
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Definition
Under age 4 years abdomen looks protuberant when child is both supine and standing
After age 4 years, potbelly remains when standing because of lumbar lordosis, but abdomen looks flat when supine
Normal movement on abdomen includes respirations, which remain abdominal until 7 years |
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Term
| When palpating a child, what do you find? |
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Definition
Remains easily palpable 1 to 2 cm below right costal margin; edge is soft and sharp and moves easily
Easily palpable, on the left, the spleen also is easily palpable with a soft, sharp, movable edge |
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Term
| When percussing a child, what do you find? |
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Definition
| Percussion of liver span measures about 3.5 cm at age 2 years, 5 cm at age 6 years, and 6 to 7 cm during adolescence |
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Term
| When inspecting an aging adult, what do you find? |
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Definition
you may note increased deposits of subcutaneous fat on abdomen and hips because it is redistributed away from extremities
Abdominal musculature is thinner and has less tone than that of younger adult, so in absence of obesity you may note peristalsis
Because of thinner, softer abdominal wall, organs may be easier to palpate, in the absence of obesity
Liver is easier to palpate; normally, you will feel liver edge at or just below costal margin |
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Term
| When palpating an aging adult, what do you find? |
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Definition
With distended lungs and depressed diaphragm, liver can be palpated lower, descending 1 to 2 cm below costal margin with inhalation
Kidneys are easier to palpate |
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Term
| What causes abdominal distention? |
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Definition
Obesity
Air or gas
Ascites
Ovarian cyst
Pregnancy
Feces
Tumor |
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Term
| What are some abnormalities of the abdomen upon inspection? |
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Definition
Umbilical hernia
Epigastric hernia
Incisional hernia
Diastasis recti |
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Term
| What are some abnormal bowel sounds of the abdomen? |
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Definition
Succussion splash
Hypoactive bowel sounds
Hyperactive bowel sounds |
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Term
| What are abnormal finding upon palpitation? |
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Definition
Enlarged liver
Enlarged nodular liver
Enlarged gallbladder
Enlarged spleen
Enlarged kidney
Aortic aneurysm |
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