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45 Cards in this Set

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Solid Viscera
viscera that don't change shape on daily basis
Solid viscera examples
liver, uterus, kidneys, adrenals, pancreas, spleen, ovaries
Hollow Viscera
viscera that change shape on a daily basis
Hollow Viscera examples
stomach, gall bladder, intestines, bladder, colon
Why visceral pain refers
brain has no felt image for internal organs ... pain is referred to a site where the organ was located in fetal development
Abdominal Changes due to Age
fat accumulation - salivation decreases - decreased gastric motility - (-) gastric acid secretion - (+) incidence of gallstones, (-) liver size, constipation
(-) gastric acid secretion puts older adult at risk for ...
anemia due to less acid to break down B12
issues with decreased liver size
still works yet blood flow to liver decreases ... which decreases how fast body metabolizes meds ... may cause toxicity due to delayed metabolism
Cultural Considerations ... abdominal
lactose intolerance ... NA, AA, Asians --- bloating, increased gas, discomfort, diarrhea
emitis
vomit
Lifestyle Risks ... abdominal
ETOH - other drugs - fast foods - stress (appetite changes) - infectious disease exposure
Abdominal Subjective data
appetite - dysphagia - food intolerance - abdominal pain - N/V/D - bowel habits - meds - PMH - nutritional assessment
occult blood
blood can't see
black tarry stool
upper GI bleed
rectal blood in stool
frank red blood
what does stool look like w/ hepatitis
gray stool
screening vs diagnostic
screening .. have risk factor but no S & S ---- diagnostic .. have S & S using to determine/ confirm problem
Objective Data Collection - Abdominal
Inspect ... THEN auscultate ... palpate ... percuss
Abdominal Inspection
shape - symmetry - color - lesions or scars - pulsations (aortic) - level of comfort
scaphoid
convex abdomen when supine - under nourished
protuberant
distended abdomen
Reasons for Protuberance
fat - fetus - feces - flatus - fibroid - fluid - fetal growth
pyrosis
heartburn
Describe Abdominal Ascultation
bowel sounds - hyper active, normal, hypo active (none for 5 minutes) ... start at RLQ work around clockwise ... bowel sounds usually return 12 hrs after surgery
where listen for bruit in abdomen
aorta, renal, illiac, femoral --- listen w/ diaphragm --- turbulent flow when atherosclorosis present
What expect to hear when percuss abdomen
tympany ... hollow --- hear dullness over organ
liver span
percuss to check -- normal 6-12cm
hepatamegally
enlarged liver -- >12cm
When can adjust location of liver?
pregnancy, ascites, pulmonary edema
Percussing Spleen
at anterior axillary line ... change in percussion from tympany to dull with full inspiration = (+) spleen percussion sign.......splenomegaly
CVA Tenderness
Costal Vetebral Angle Tenderness ---- indirect fist percussion causes tissue to vibrate as opposed to making a sound. Sharp pain occurs on percussion w/ kidney inflamation
Abdominal Palpation
moving clockwise from RLQ light palpation 1-3cm feeling for surface abnormalities ... then 2nd pass deep palpation --- if pain present palpate last
Blumberg's Sign
Rebound Tenderness ... on opposite side from pain, press in with fingertips ... ? more pain when press or when release. More pain on release w/ peritenitis & appendisitis
Rebound Tenderness
same as Blumberg's sign
Murphy's Sign
palpating for inflammation of gallbladder ... hold fingers under liver boarder & ask person to take deep breath .... (+) test is presence of pain
Everted Umbilicus present with ...
pregnancy; ascites or underlying mass; umbilical hernia
Bluish Periumbilical color occurs w/
intraabdominal bleeding
Abdominal dullness occurs w/
distended bladder, adipose tissue, fluid or a mass
Hyperresonant abdominal sounds occur with
gaseous distention
Palpate Aorta where?
upper abdomen just to left of midline
RUQ organs
Liver - gallbladder - duodenum - R kidney & adrenal - ascending & transverse colon - hepatic flexure of colon
LUQ organs
Stomach - spleen - L lobe of liver - pancreas - L kidney & adrenal - transverse & descending colon - splenic flexure of colon
RLQ organs
Cecum - appendix - R ovary - R ureter - R spermatic cord
LLQ organs
Descending colon - sigmoid colon - L ovary - L ureter - L spermatic cord
Midline organs
Uterus - bladder - aorta