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77 Cards in this Set
- Front
- Back
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RUQ organs (6)
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"liver
gallbladder duodenum right kidney hepatic flexure of colon pylorus of stomach" |
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RLQ organs (4)
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"cecum
appendix right ovary right fallopian tube" |
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LUQ organs (6)
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"stomach
spleen left kidney tail of pancreas splenic flexure of colon" |
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LLQ organs (3)
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"sigmoid colon
left ovary left fallopian tube" |
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Epigastric organs (3)
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"Stomach
Pancreas (body/head) Aorta" |
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Quadrant: liver
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RUQ
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Quadrant: gall bladder
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RUQ
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Quadrant: duodenum
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RUQ
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Quadrant: kidney
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R/L UQ
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Quadrant: hepatic flexure of colon
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RUQ
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Quadrant: cecum
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RLQ
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Quadrant: appendix
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RLQ
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Quadrant: ovaries
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R/L LQ
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Quadrant: fallopian tubes
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R/L LQ
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Quadrants: stomach + pylorus
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"LUQ
epigastric pylorus is RUQ" |
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Quadrant: spleen
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LUQ
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Quadrants: pancreas
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"tail - LUQ
head/body - epigastric" |
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Quadrant: splenic flexure of colon
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LUQ
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Quadrant: sigmoid colon
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LLQ
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Quadrant: aorta
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epigastric
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Findings of ascites
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"Positional shift in fluid (when rolling to side)
Shifting dullness via percussion (tympanic area shifts to opposite side of fluid when patient rolls on side) Fluid wave (wave passes through a hand - normally hand blocks subq waves) Buldging flanks, flank dullness, umbilical hernia" |
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Where is liver span measured?
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midclavicular line
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Normal liver span?
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<10cm
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What are the symptoms of an AAA?
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"Low back, flank, abdominal pain
Pulsating abdominal mass Widened aorta felt in deep palpation Bruit on auscultation Hypotension, abdominal distension if ruptured" |
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Symptoms and Exam findings of diverticulitis
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"Triad: Fever, cramping LLQ pain, leukocytosis
Symptoms: Cramping, LLQ pain (typically sigmoid), diarrhea, constipation, feeling of not emptying rectum, fever Signs: Guarding, rebound tenderness, palpable mass" |
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Where is a diverticulum typically found?
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LLQ - sigmoid colon
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Where is traube's space, what does it detect?
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"Sixth rib, left axillary line, costal margin
Splenomegaly if dull since usually stomach sits here" |
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How to palpate for splenomegaly?
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"press hand inward under left costal margin, use other hand to press spleen from the axilla
Feel the tip during inspiration" |
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Is a normal spleen palpable?
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No
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What is rebound tenderness?
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Pain upon removing pressure
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Symptoms/findings of peritonitis?
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"Symptoms: immobile, moving makes pain worse, fever
Signs: rebound tenderness, rigid abdomen due to muscle spasm, fever, tachycardia, loss of hepatic dullness (free air in peritoneum), hypotensive if septic" |
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What is tympanic to percussion in the abdomen?
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Stomach, intestine, colon gas
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When are the bladder, spleen, and uterus detectable by percussion?
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Usually not detectable, unless splenomegaly, distended bladder, or enlarged uterus
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Where are the boundries for draping in abdomenal exam?
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From xiphoid to pubic symphysis
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How should you palpate if an area is tender?
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Palpate most distal quadrant first
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Findings of pyelonephritis
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"Fever, chills, N/V
Flank pain (CVA) Dysuria - frequency, urgency, burning, suprapubic pain, hematuria/cloudy" |
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Where to listen for renal bruits?
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2 inches above umbilicus, 1-2 inches lateral
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Where to listen for AAA bruits?
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2 inches above umbilicus
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Appendicitis signs/symptoms?
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"Abdominal pain - periumbilical, localizes to RLQ within 12-18 hours (McBurney's point)
Psoas sign - pain w/ right leg fully extended, when patient is on his side Obturaror sign - flexion + internal rotation of the hip N/V, tachycardia" |
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Cirrhosis findings in the skin
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"Jaundice
palmar erythema (alcohol abuse) spider angiomata ecchymosis (due to thrombocytopenia/coag factor deficiency) caput medusae (dilated superficial periumbilical vein) hemochromatosis (increased pigment) xanthoma (primary biliary cirrhosis -> fat buildup) Needle tracks (viral hepatitis)" |
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Cirrhosis findings in the eye
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"Kayser fleischer rings in Wilson's disease
Scleral icterus" |
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Cirrhosis breath findings
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Fetor hepaticus (musty odor of breath/urine)
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Cirrhosis chest findings
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Gynecomastia in men
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Cirrhosis abdomen findings
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"Tender hepatomegaly (congestive hepatomegaly)
Small nodular liver Palpable spleen (due to portal HTN) Venous hum auscultated over periumbilical veins (due to portal HTN) Ascites (due to portal HTN, hypoalbuminemia)" |
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Cirrhosis rectal findings
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"Hemorrhoids (portal HTN)
Guaiac positive stools (alcoholic gastritis, bleeding varices, PUD, bleeding hemorrhoids)" |
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Cirrhosis genitalia findings
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Testicular atrophy in males (hyperestrogenemia?)
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Cirrhosis extremity findings
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"Pedal edema (hypoalbuminemia)
Arthropathy (hemochromatosis)" |
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Cirrhosis neurologic findings
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"Asterixis (hepatic encephalopathy)
Choreoathetosis Dysarthria (wilson's disease)" |
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Referred pain: esophagus
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Substernal
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Referred pain: diaphragm
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Shoulder
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Referred pain: stomach
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Epigastric
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Referred pain: duodenum
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Epigastric
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Referred pain: gallbladder
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Epigastric
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Referred pain: liver
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Epigastric
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Referred pain: bile ducts
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Epigastric
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Referred pain: pancreas
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Epigastric Midback
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Referred pain: biliary tract
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Right scapula (for acute cholecystitis)
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Referred pain: aorta
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Midback
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Referred pain: small intestine
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Periumbilical
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Referred pain: colon
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Hypogastrium (below umbilicus)
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Referred pain: rectum
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Sacrum
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Inflammatory lymph nodes - description
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< 2 cm, mobile, tender, typically cervical
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Malignanty lymph nodes - description
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Present for months, grow larger, firm, immobile, nontender
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Acute hepatitis signs/symptoms:
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"Nonspecific flu like symptoms
+ loss of appetite, aversion to smoking, dark urine, jaundice, abdominal discomfort Hepatosplenomegaly, lymphadenopathy" |
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Chronic hepatitis signs/symptoms:
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"Nonspecific flu like symptoms - often extreme fatigue
Advanced symptoms include: weight loss, bruising/bleeding, peripheral edema, ascites, portal HTN, hepatic encephalopathy, hepatorenal syndrome" |
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Hepatic encephalopathy symptoms
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"Lack of awareness, poor attention -> lethargy, confusion, somnolence -> coma
Asterixis present in intermediate stages" |
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Hepatic encephalopathy microscopic pathology
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Microscopic: Alzheimer type II astrocytes - enlarged, vesicular nucleus, marginated, chromatin, scanty cytoplasm (not-specific)
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Hepatic encephalopathy - pathophysiology
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Pathogenesis: unknwon, liver involved in breaking down substances, so damage you get increased ammonia and endogenous benzodiazepine-like substances thought to play a role (ammonia might affect glia since it is involved in glutamate -> glutamine, and glutamine damages glia)
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Signs and symptoms of portal HTN
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"Ascites
Portacaval anastomoses: esophageal varices, gastric varices, anorectal varices, caput medusae" |
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Signs and symptoms of cholecystolithiasis
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"RUQ/epigastric pain, tenderness, distension
Intermittent pain early on -> constant Pain referred to R scapular region Murphy's sign - cessation of inspiration when pressure put on inferior border of liver Non-specific signs: nausea, etc" |
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Inguinal triangle borders
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Lateral margin of the rectus sheath, inferior epigastric vessels, inguinal ligament
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Direct hernia / indirect hernia - relationship to epigastric vessels?
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Indirect - lateral to the vessels, direct - medial to the vessels
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Direct hernia / indirect hernia - are either covered by the internal spermatic faschia?
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Indirect is
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Which hernia type enters through the inguinal ring?
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indirect
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What is diastasis recti?
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Defect in linea alba - ridge down midline of the abdomen
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What is a ventral hernia?
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Hernia through wall of the abdomen, often through site of surgical incision
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What is levine's sign?
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Patient clenches fist over sternum
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