Abdomen Chpt 17 Part 2 Seidel

Front 1

A glistening, taut appearance on the abdomen suggests ___

Back 1

ascites

Front 2

A bluish periumbilical discoloration (Cullen sign) suggests ____

Back 2

intraabdominal bleeding

Front 3

What can produce striae?

Back 3

pregnancy, weight gain, Abdominal tumor or ascites

Front 4

What color are the striae of Cushing Disease?

Back 4

remain purplish

Front 5

A pearl-like, enlarged umbilical node may signal _____

Back 5

intraabdominal lymphoma

Front 6

The presence of scarring should alert you to the possibility of _____

Back 6

internal adhesions.

Front 7

Contuor common in well-muscled, athletic adults

Back 7

FLAT

Front 8

contour is characteristic of young children

Back 8

rounded or convex

Front 9

Why would a adult have a rounded or convex contour?

Back 9

result of subcutaneous fat or poor muscle tone from inadequate exercise.

Front 10

Contour of thin adults?

Back 10

scaphoid or concave

Front 11

inflammation, swelling, or bulges of the umbilicus may indicate

Back 11

hernia

Front 12

Distention from the umbilicus to the symphysis can be caused by ___, ___, ___, ___

Back 12

ovarian tumor, pregnancy, uterine fibroids, or a distended bladder.

Front 13

distention of the upper half, above the umbilicus, can mean ___, ___, __

Back 13

carcinoma, pancreatic cyst, or gastric dilation.

Front 14

Asymmetric distention or protrusion may indicate ___, ___, ___, ___, ___

Back 14

hernia, tumor, cysts, bowel obstruction, or enlargement of abdominal organs.

Front 15

You are with a patient whose abdomen is significantly distended and whose bowel sounds are hypoactive or even absent. There is no particular pain and you feel no masses. The reflexes are hypoactive. You know that the patient is on diuretics for treatment of hypertension. DX?

Back 15

Think hypokalemia. Diuretics/distention/deficiency of K+. Steroids can do the same thing.

Front 16

Protrusion of the navel indicates an

Back 16

umbilical hernia.

Front 17

hernia contains a bit of fat and is felt as a small, tender nodule, midline of the epigastrium

Back 17

hernia of the linea alba

Front 18

A nonreducible hernia in which the blood supply to the protruded contents is obstructed is _____

Back 18

strangulated and requires immediate surgical intervention.

Front 19

Diastasis recti is often caused by

Back 19

pregnancy or obesity. The condition is of little clinical significance.

Front 20

Male respiration movement

Back 20

abdominal respiration

Front 21

Female respiration movement

Back 21

costal movement.

Front 22

Limited abdominal motion associated with respiration in adult males may indicate

Back 22

peritonitis or disease

Front 23

rippling movement across a section of the abdomen

Back 23

peristalsis

Front 24

What does the presence of peristalsis in an adult mean

Back 24

intestinal obstruction

Front 25

Marked pulsation may occur as the result of _____

Back 25

increased pulse pressure or abdominal aortic aneurysm.

Front 26

frequency of bowel sounds?

Back 26

5 to 35 per minute

Front 27

Loud prolonged gurgles are called

Back 27

borborygmi (stomach growling)

Front 28

Increased bowel sounds may occur with ___, ___, ___

Back 28

gastroenteritis, early intestinal obstruction, or hunger

Front 29

High-pitched tinkling sounds suggest

Back 29

intestinal fluid and air under pressure, as in early obstruction.

Front 30

Decreased bowel sounds occur with ___,___

Back 30

peritonitis and paralytic ileus

Front 31

Describe a friction rub of the liver or spleen

Back 31

high pitched and are heard in association with respiration.

Front 32

What do friction rubs of the abdomen indicate

Back 32

inflammation of the peritoneal surface of the organ from tumor, infection, or infarct.

Front 33

Describe the sound of a venous hum

Back 33

soft, low pitched, and continuous

Front 34

A venous hum occurs with ____

Back 34

increased collateral circulation between portal and systemic venous systems.

Front 35

A distended bladder produces

Back 35

dullness in the suprapubic area.

Front 36

Sound over air-filled viscera

Back 36

Tympany

Front 37

Sound of the base of the lung

Back 37

Hyperresonance

Front 38

Sound Over lung tissue and some times over the abdomen

Back 38

Resonance

Front 39

Sound Over solid organs adjacent to air-filled structures

Back 39

Dullness

Front 40

A lower liver border that is more than 2 to 3 cm (¾ to 1 inch) below the costal margin may indicate ___ due to ___

Back 40

organ enlargement or downward displacement of the diaphragm because of emphysema or other pulmonary disease.

Front 41

upper border of the liver usually begins at the

Back 41

fifth to seventh intercostal space.

Front 42

Dullness of the liver extending above the fifth intercostal space suggests

Back 42

upward displacement from abdominal fluid or masses.

Front 43

Vertical span of the liver is usually ?

Back 43

6 to 12 cm (2½ to 4½ inches).

Front 44

Errors in estimating liver span can occur when ____

Back 44

the dullness of pleural effusion or lung consolidation obscures the upper liver border, leading to overestimation of size.

Front 45

What can obscure the dullness of the lower liver border, leading to underestimation of liver size.

Back 45

gas in the colon may produce tympany in the right upper quadrant

Front 46

The usual liver span at the midsternal line is

Back 46

4 to 8 cm (1½ to 3 inches). Spans exceeding 8 cm suggest liver enlargement.

Front 47

small area of splenic dullness from the ____

Back 47

sixth to the tenth rib

Front 48

Where do you percuss for gastric air bubbles

Back 48

left lower anterior rib cage and left epigastric region

Front 49

Which has a lower tympany pitch, the gastric bubble vs intestine

Back 49

gastric bubble

Front 50

Light palpation is particularly useful in identifying ___ and ___

Back 50

muscular resistance and areas of tenderness

Front 51

light palpation produces sense of resistance. 2 things

Back 51

large mass or distended structure

Front 52

Rigidity of the abdomen is common from __

Back 52

peritoneal irritation.

Front 53

What are the 6 areas of cutaneous hypersensitivity on the abdomen?

Back 53

Gallbladder, Left side of Stomach, Kidney, Cecum and appendix, Ovary and tube, and Ureter

Front 54

How do you ID peritoneal irritation through cutaneous hypersensitivity?

Back 54

Lift a fold of skin away from underlying muscle or, B, stimulate the skin with a sharp point or a broken tongue blade.

Front 55

Deep palpation is necessary to thoroughly delineate ___ and ___

Back 55

abdominal organs and to detect less obvious masses

Front 56

Deep pressure may also evoke tenderness in the healthy person over __, ___, ___, ___

Back 56

cecum, sigmoid colon, aorta, and in the midline near the xiphoid process.

Front 57

soft, rounded, boggy mass in the cecum and in the ascending, descending, or sigmoid colons

Back 57

presence of feces in the colon, often mistaken for an abdominal mass,

Front 58

Other structures that are sometimes mistaken for masses in the abdomen

Back 58

lateral borders of the rectus abdominis muscles, the uterus, aorta, sacral promontory, and common iliac artery

Front 59

What is the point of the scratch test for the abdomen?

Back 59

auscultation to detect the differences in sound transmission over solid and hollow organs. Place the stethoscope over the liver and with the finger of your other hand scratch the abdominal surface lightly, moving toward the liver border. When you encounter the liver, the sound you hear in the stethoscope will be intensified.

Front 60

How do you detect liver tenderness if the liver is not palpable?

Back 60

indirect fist percussion. Place the palmar surface of one hand over the lower right rib cage, and then strike your hand with the ulnar surface of the fist of your other hand

Front 61

Where do you palpate the gallbladder?

Back 61

below the liver margin at the lateral border of the rectus abdominis muscle

Front 62

palpable, tender gallbladder indicates

Back 62

cholecystitis

Front 63

palpable, NONtender gallbladder indicates

Back 63

common bile duct obstruction

Front 64

What is Murphy sign for?

Back 64

inflamed gallbladder

Front 65

The percussion note over an enlarged spleen

Back 65

dull because the spleen displaces bowel

Front 66

The percussion note over an enlarged kidney is

Back 66

resonant because the kidney is deeply situated behind the bowel.

Front 67

A prominent lateral pulsation on Aorta suggests

Back 67

aortic aneurysm

Front 68

Direction of Aorta pulse

Back 68

Anterior

Front 69

Absence of the abdominal reflex may indicate

Back 69

pyramidal tract lesion.

Front 70

protuberant abdomens or flanks that bulge in the supine position

Back 70

Ascites

Front 71

What is the auscultatory change in a healthy person over the pelvic border?

Back 71

percussion note is first dull and then changes sharply to a loud note at the pelvic border. ascites the percussion note changes above the pelvic border at the fluid level.

Front 72

The sudden onset of severe epigastric pain is, of course, unsettling. If that pain is continuous, unrelieved, and radiating (often) to the groin and back, think ___

Back 72

acute pancreatitis.

Front 73

Dx when vomitus smells like Fetid

Back 73

gastrointestinal obstruction

Front 74

Dx when vomitus smells like Kerosene

Back 74

hydrocarbon ingestion

Front 75

Dx when vomitus smells like Violets

Back 75

sometimes from turpentine

Front 76

Dx when vomitus smells like Garlic

Back 76

arsenic

Front 77

Patients with an organic cause for abdominal pain are generally

Back 77

not hungry think appendicitis or intraabdominal infection.

Front 78

Pain not directed to the navel but goes immediately to a fixed point

Back 78

significant physical importance.

Front 79

What is Apley rule?

Back 79

The farther from the navel the pain, the more likely it will be organic in origin

Front 80

People with organic abdominal pain keep their eyes ___ on palpation

Back 80

OPEN

Front 81

Initially periumbilical or epigastric; colicky; later becomes localized to RLQ, often at McBurney point

Back 81

Appendicitis

Front 82

Guarding, tenderness; + iliopsoas and + obturator signs, RLQ skin hyperesthesia; anorexia, nausea, or vomiting after onset of pain; low-grade fever; + Aaron, Rovsing, Markle, and McBurney signs*

Back 82

Appendicitis

Front 83

Onset sudden or gradual; pain generalized or localized, dull or severe and unrelenting; guarding; pain on deep inspiration

Back 83

Peritonitis

Front 84

Shallow respiration; + Blumberg, Markle, and Ballance signs; reduced or absent bowel sounds, nausea and vomiting; + obturator and iliopsoas tests

Back 84

Peritonitis

Front 85

Severe, unrelenting RUQ or epigastric pain; may be referred to right subscapular area

Back 85

Cholecystitis

Front 86

RUQ tenderness and rigidity, + Murphy sign, palpable gallbladder, anorexia, vomiting, fever, possible jaundice

Back 86

Cholecystitis

Front 87

Dramatic, sudden, excruciating LUQ, epigastric, or umbilical pain; may be present in one or both flanks; may be referred to left shoulder

Back 87

Pancreatitis

Front 88

Epigastric tenderness, vomiting, fever, shock; + Grey Turner sign; + Cullen sign: both signs occur 2 to 3 days after onset

Back 88

Pancreatitis

Front 89

Pain Lower quadrant, worse on left

Back 89

Salpingitis

Front 90

Nausea, vomiting, fever, suprapubic tenderness, rigid abdomen, pain on pelvic examination

Back 90

Salpingitis

Front 91

Pain Lower quadrant, increases with activity

Back 91

Pelvic inflammatory disease

Front 92

Tender adnexa and cervix, cervical discharge, dyspareunia

Back 92

Pelvic inflammatory disease

Front 93

Pain Epigastric, radiating down left side of abdomen especially after eating; may be referred to back

Back 93

Diverticulitis

Front 94

Flatulence, borborygmus, diarrhea, dysuria, tenderness on palpation

Back 94

Diverticulitis

Front 95

Pain Abrupt RUQ; may be referred to shoulders

Back 95

Perforated gastric or duodenal ulcer

Front 96

Abdominal free air and distention with increased resonance over liver; tenderness in epigastrium or RUQ; rigid abdominal wall, rebound tenderness

Back 96

Perforated gastric or duodenal ulcer

Front 97

Abrupt, severe, spasmodic; referred to epigastrium, umbilicus

Back 97

Intestinal obstruction

Front 98

Distention, minimal rebound tenderness, vomiting, localized tenderness, visible peristalsis; bowel sounds absent (with paralytic obstruction) or hyperactive high pitched (with mechanical obstruction)

Back 98

Intestinal obstruction

Front 99

Pain Referred to hypogastrium and umbilicus

Back 99

Volvulus

Front 100

Distention, nausea, vomiting, guarding; sigmoid loop volvulus may be palpable

Back 100

Volvulus

Front 101

Steady throbbing midline over aneurysm; may radiate to back, flank

Back 101

Leaking abdominal aneurysm

Front 102

Nausea, vomiting, abdominal mass, bruit

Back 102

Leaking abdominal aneurysm

Front 103

Pain Episodic, severe, RUQ, or epigastrium lasting 15 min to several hours; may be referred to subscapular area, especially right

Back 103

Biliary stones, colic

Front 104

RUQ tenderness, soft abdominal wall, anorexia, vomiting, jaundice, subnormal temperature

Back 104

Biliary stones, colic

Front 105

Pain Intense; flank, extending to groin and genitals; may be episodic

Back 105

Renal calculi

Front 106

Fever, hematuria; + Kehr sign

Back 106

Renal calculi

Front 107

Pain Lower quadrant; referred to shoulder; with rupture is agonizing

Back 107

Ectopic pregnancy

Front 108

Hypogastric tenderness, symptoms of pregnancy, spotting, irregular menses, soft abdominal wall, mass on bimanual pelvic examination; ruptured: shock, rigid abdominal wall, distention; + Kehr, Cullen signs

Back 108

Ectopic pregnancy

Front 109

Pain Lower quadrant, steady, increases with cough or motion

Back 109

Ruptured ovarian cyst

Front 110

Vomiting, low-grade fever, anorexia, tenderness on pelvic examination

Back 110

Ruptured ovarian cyst

Front 111

Pain Intense; LUQ, radiating to left shoulder; may worsen with foot of bed elevated

Back 111

Splenic rupture

Front 112

Shock, pallor, lowered temperature

Back 112

Splenic rupture

Front 113

Hypogastric pain; crampy, variable, infrequent; associated with bowel function

Back 113

Irritable bowel syndrome

Front 114

Crampy pain after eating milk or milk products

Back 114

Lactose intolerance

Front 115

Localized pain Abdominal tenderness, fever

Back 115

Diverticular disease

Front 116

Colicky or dull and steady pain that does not progress and worsen; Fecal mass palpable, stool in rectum

Back 116

Constipation

Front 117

Pain related to menses, intercourse; Palpable myoma(s)

Back 117

Uterine fibroids

Front 118

Burning gnawing pain in mid-epigastrium, worsens with recumbency; Negative physical examination

Back 118

Esophagitis/gastroesophageal reflux disease

Front 119

Burning or gnawing pain; May have epigastric tenderness on palpation

Back 119

Peptic ulcer

Front 120

Constant burning pain in epigastrium; May be accompanied by nausea, vomiting, diarrhea, or fever

Back 120

Gastritis

Front 121

What can produce a Quality and Onset of Abdominal Pain: Burning

Back 121

Peptic ulcer

Front 122

Quality and Onset of Abdominal Pain: Cramping

Back 122

Biliary colic, gastroenteritis

Front 123

Quality and Onset of Abdominal Pain: Colic

Back 123

Appendicitis with impacted feces; renal stone

Front 124

Quality and Onset of Abdominal Pain: Aching

Back 124

Appendiceal irritation

Front 125

Quality and Onset of Abdominal Pain: Knifelike

Back 125

Pancreatitis

Front 126

Quality and Onset of Abdominal Pain: Ripping, tearing

Back 126

Aortic dissection

Front 127

Quality and Onset of Abdominal Pain: Gradual onset

Back 127

Infection

Front 128

Quality and Onset of Abdominal Pain: Sudden onset

Back 128

Duodenal ulcer, acute pancreatitis, obstruction, perforation

Front 129

sudden, dramatic change from mild, even vague abdominal pain that is there but not particularly distressing to a sudden onset of severe abdominal tenderness in the hypogastric area, particularly on the involved side. Rigidity and rebound may come on early or late

Back 129

Ectopic Pregnancy

Front 130

rigidity, a positive psoas sign, fever, or rebound tenderness are physical examination findings that increase the likelihood of

Back 130

appendicitis

Front 131

What is rebound tenderness test for?

Back 131

peritoneal inflammation

Front 132

What is a positive Blumberg sign?

Back 132

return to position (rebound) of the structures that were compressed by your fingers causes a sharp stabbing pain at the site of peritoneal inflammation

Front 133

What is Ballottement ?

Back 133

palpation technique used to assess a floating mass, such as the head of a fetus

Front 134

Pain or distress occurs in the area of the patient's heart or stomach on palpation of McBurney point; Appendicitis
What sign?

Back 134

Aaron sign

Front 135

Fixed dullness to percussion in left flank, and dullness in right flank that disappears on change of position; Peritoneal irritation
What sign?

Back 135

Ballance sign

Front 136

Rebound tenderness; Peritoneal irritation; appendicitis
What sign?

Back 136

Blumberg sign

Front 137

Ecchymosis around umbilicus; Hemoperitoneum; pancreatitis; ectopic pregnancy
What sign?

Back 137

Cullen sign

Front 138

Absence of bowel sounds in right lower quadrant; Intussusception
What sign?

Back 138

Dance sign

Front 139

Ecchymosis of flanks; Hemoperitoneum; pancreatitis
What sign?

Back 139

Grey Turner sign

Front 140

Abdominal pain radiating to left shoulder; Spleen rupture; renal calculi; ectopic pregnancy
What test?

Back 140

Kehr sign

Front 141

Patient stands with straightened knees, then raises up on toes, relaxes, and allows heels to hit floor, thus jarring body. Action will cause abdominal pain if positive; Peritoneal irritation; appendicitis
What test?

Back 141

Markle (heel jar) sign

Front 142

Rebound tenderness and sharp pain when RLQ is palpated; Appendicitis
What sign?

Back 142

McBurney sign

Front 143

Abrupt cessation of inspiration on palpation of gallbladder; Cholecystitis
What sign?

Back 143

Murphy sign

Front 144

Pain down the medial aspect of the thigh to the knees, Strangulated obturator hernia
What sign?

Back 144

Romberg-Howship sign

Front 145

Right lower quadrant pain intensified by left lower quadrant abdominal palpation; Peritoneal irritation; appendicitis

Back 145

Rovsing sign

Front 146

A scaphoid abdomen in infants suggests

Back 146

abdominal contents are displaced into the thorax. diaphragmatic hernia In newborns

Front 147

In infants, distended veins across the abdomen are an unexpected finding suggestive of ___

Back 147

vascular obstruction or abdominal distention or obstruction.

Front 148

Spider nevi may indicate

Back 148

Liver disease

Front 149

Any intestinal structure present in the umbilical cord or protruding into the umbilical area and visible through a thick transparent membrane suggests an

Back 149

omphalocele

Front 150

Once the umbilical stump has separated, serous or serosanguineous discharge may indicate

Back 150

granuloma

Front 151

Which is ok and which is not in an infant: 1. Herniation through the rectus abdominis muscles vs 2. Diastasis rectus abdominis

Back 151

1. no 2. yes

Front 152

Peristaltic waves may sometimes be seen in thin, malnourished infants, but their presence usually suggests an

Back 152

intestinal obstruction such as pyloric stenosis.

Front 153

The bruit of stenosis has a _____; the bruit of arteriovenous fistula is _____.

Back 153

The bruit of stenosis has a high frequency and is soft; the bruit of arteriovenous fistula is continuous.

Front 154

In infants and young children, Any increase in spleen size may indicate ___

Back 154

blood dyscrasias or septicemia.

Front 155

The liver edge may be palpable at ________ in infants and toddlers

Back 155

1 to 3 cm below the right costal margin

Front 156

A sausage-shaped mass in the left lower quadrant may indicate

Back 156

feces in the sigmoid colon associated with constipation

Front 157

A midline suprapubic mass suggests

Back 157

Hirschsprung disease, in which feces fill the rectosigmoid colon

Front 158

A sausage-shaped mass in the left or right upper quadrant may indicate

Back 158

intussusception

Front 159

almond-shaped mass on after the infant vomits deep palpation in the right upper quadrant immediately after the infant vomits

Back 159

pyloric stenosis

Front 160

Almost all other palpable masses in the abdomen of the newborn are

Back 160

renal in origin

Front 161

In infants and toddler, A distended bladder, felt as a firm, central dome-shaped structure in the lower abdomen, may indicate ___

Back 161

urethral obstruction or central nervous system defects.

Front 162

It is normal for a child to use abdominal respiration until what ages?

Back 162

6-7 years old

Front 163

Restricted abdominal respiration in young children can be caused by

Back 163

peritoneal irritation or an acute abdomen.

Front 164

In children, upper edge of the liver should be detected by percussion at the

Back 164

sixth intercostal space

Front 165

In children, The lower edge of the liver may be palpated either at, or

Back 165

1 to 2 cm below, the right costal margin.

Front 166

average duration of pregnancy

Back 166

280 days, or 40 weeks.

Front 167

What is the McDonald rule?

Back 167

During the second and third trimesters, the McDonald rule can also be used to estimate the duration of the pregnancy from fundal height measurement. divide the height of the fundus (in centimeters) by 3.5; the resultant figure is said to equal the duration of pregnancy in lunar months.

Front 168

Standard FM count criteria

Back 168

10 times in 1 hour to 10 times in 12 hours

Front 169

When should someone worry about FM assessment?

Back 169

occurrence of three or fewer FMs in 2 hours for 2 consecutive days while the woman is at rest in left lateral position signals the need for further evaluation of fetal well-being.

Front 170

Assessment of fetal position can be performed using the four steps of the

Back 170

Leopold maneuvers

Front 171

When do Uterine contractions begin ?

Back 171

third month of gestation (Braxton Hicks contractions)

Front 172

when are uterine contraction abnormal?

Back 172

more than 4 to 6 uterine contractions per hour before 37 weeks of gestation requires evaluation.

Front 173

Symptoms can range from dysphagia to nausea, vomiting, anorexia, and hematemesis; and can include changes in stool frequency, size, consistency, or color.

Back 173

gastrointestinal cancer increases with age

Front 174

The Fs of Abdominal Distention

Back 174

Fat
Fluid
Feces
Fetus
Flatus
Fibroid
Full bladder
False pregnancy
Fatal tumor

Front 175

Congenital: Hirschsprung disease Obstruction
Neoplasms
Stricture of colon
Topical: painful hemorrhoids or fissure
Impacted feces
Prolapse of the rectum
Anorexia and depression
Temperature high, dehydration results
Endocrine: hypothyroidism
Diet, diverticulitis, and drugs

Back 175

Causes of Constipation: CONSTIPATED

Front 176

Abdominal or anal ""sausage""
Blood from the rectum (red currant jelly)
Colic: babies draw up their legs
Distention, dehydration, and shock
Emesis
Face pale"

Back 176

Intussusception in Infants: ABCDEF

Front 177

" * Involuntary rigidity of abdominal muscles
* Tenderness and guarding
* Absent bowel sounds
* Positive obturator test (p. 555)
* Positive iliopsoas test (p. 555)
* Rebound tenderness (Blumberg sign and McBurney sign; see Table 17-6)
* Abdominal pain on walking
* Positive heel jar test (Markle sign, see Table 17-6)
* Right lower quadrant pain intensified by left lower quadrant abdominal palpation (positive Rovsing sign, see Table 17-6)
"

Back 177

Findings in Peritoneal Irritation

Front 178

"Area of Pain?
Duodenal ulcer
Hepatitis
Hepatomegaly
Pneumonia
Cholecystitis"

Back 178

Right Upper Quadrant

Front 179

"Area of Pain?
Appendicitis
Salpingitis
Ovarian cyst
Ruptured ectopic pregnancy
Renal/ureteral stone
Strangulated hernia
Meckel diverticulitis
Regional ileitis
Perforated cecum"

Back 179

Right Lower Quadrant

Front 180

"Area of Pain?
Intestinal obstruction
Acute pancreatitis
Early appendicitis
Mesenteric thrombosis
Aortic aneurysm
Diverticulitis"

Back 180

Periumbilical

Front 181

"Area of Pain?
Ruptured spleen
Gastric ulcer
Aortic aneurysm
Perforated colon
Pneumonia"

Back 181

Left Upper Quadrant

Front 182

"Area of Pain?
Sigmoid diverticulitis
Salpingitis
Ovarian cyst
Ruptured ectopic pregnancy
Renal/ureteral stone
Strangulated hernia
Perforated colon
Regional ileitis
Ulcerative colitis"

Back 182

Left Lower Quadrant

Front 183

"Landmarks for Abdominal Examination
Liver and gallbladder
Pylorus
Duodenum
Head of pancreas
Right adrenal gland
Portion of right kidney
Hepatic flexure of colon
Portions of ascending and transverse colon"

Back 183

Right Upper Quadrant (RUQ)

Front 184

"Landmarks for Abdominal Examination
Left lobe of liver
Spleen
Stomach
Body of pancreas
Left adrenal gland
Portion of left kidney
Splenic flexure of colon
Portions of transverse and descending colon"

Back 184

Left Upper Quadrant (LUQ)

Front 185

"Landmarks for Abdominal Examination
Lower pole of right kidney
Cecum and appendix
Portion of ascending colon
Bladder (if distended)
Ovary and salpinx
Uterus (if enlarged)
Right spermatic cord
Right ureter"

Back 185

Right Lower Quadrant (RLQ)

Front 186

"Landmarks for Abdominal Examination
Lower pole of left kidney
Sigmoid colon
Portion of descending colon
Bladder (if distended)
Ovary and salpinx
Uterus (if enlarged)
Left spermatic cord
Left ureter"

Back 186

Left Lower Quadrant (LLQ)