Health Assessment Chapter 20

Front 1

Gaseous Distention

Back 1

result of increased production of gas in the intestines from breakdown of certain foods and fluids; average adult passes 500 ml of gas a day; associated with altered peristalsis where gas can't move within the intestines; percussion sounds will be tympanic over the area od distention

Front 2

Abdominal Tumor

Back 2

firm to palpation and tympanic to percussion, also produces abdominal distention; ovarian and uterine tumors are common types of palpable tumors in the abdomal cavity, despite the pelvic origin.

Front 3

Ascites

Back 3

accumulation of fluid in the abdomen; it descends with gravity, resulting in dullness to percussion in the lowest point of the abdomen based on patient's position; changing position should move the fluid to shift to the most dependent point; this occurs in cirrhosis, CHF, nephrosis, peritonitis, and metastatis neoplasms

Front 4

Abdominal Bowel Sounds

Back 4

auscultation results in bowel, vascular, and rubbing sounds. Bowel sounds may be hyperactive/hypoactive and occur in any quadrant of the abdomen. Hyperactive sounds are common in gastroenteritis and diarrhea. Hypoactive sounds are common in constipation and paralytic ileus. High-pitched bowel sounds with cramping are commonly heard in intestinal obstruction.

Front 5

Abnormal Vascular Sounds

Back 5

bruit is most common, makes a blowing sound; the location can help determine the cause of the bruit. Bruits are located in the midline below the xiphoid process are caused by aortic obstruction. Bruits located at the left and right costal borders at the MCL are caused by stenosis of the arteries.

Front 6

Bruits

Back 6

Bruits located at the left and right MCL between the umbilicus and the anterior iliac spine are caused by stenosis of the iliac arteries

Front 7

Venous Hums

Back 7

constinuous sounds found in the epigastric region and around the unbilicus, caused by portal hypertension

Front 8

Friction Rubs

Back 8

harsh grating sounds found in the RUQ and LUQ, over the liver and the spleen, caused by tumors or inflammation of the underlying organs

Front 9

Common Tests for :

Acute Abdomen

Back 9

light and deep palpation; firm boarderlike abdominal wall suggests peritoneal inflammation.

Check for rebound tenderness

Front 10

Rebound Tenderness

Back 10

tenderness greater when you quickly withdraw your hand from the point of pain (A) than when you press slowly on the tender area (B) also suggests peritoneal inflammation

Front 11

Common Tests for :

Appendicitis

Back 11

test for rebound tenderness at the McBurney Point (RLQ)

Front 12

Rovsing Sign

Back 12

press deeply and evenly in the LLQ and quickly withdraw your fingers, the patient reports pain in RLQ furing LLQ pressure, suggesting appendicitis

Front 13

Psoas Sign

Back 13

place your hand just above the patient's right knee, ask the patient to raise their thigh against your hand and turn to the left side, extend the leg at the hip to stretch the iliopsoas muscle; a positive sign is pain in the RLQ suggesting appendicitis ot peritoneal inflammation

Front 14

Obturator Sign

Back 14

flex patient's right thigh at the hip with the knee bent and rotate the leg internally at the hip, to stretch the internal obtrurator. RLQ pain constitutes a positive obturator sign, suggesting inflammed appendix or peritoneal inflammation

Front 15

Abdominal Aortic Aneursym

Back 15

boring tearing pain and referred pain, auscultation reveals bruits or exagerrated pulsations, a mass may be palpable over the aorta, femoral pulses may be diminished or diffuse. patients may seem in shock, hypotensive, tachycardiac, tachypneic, pale, cool, clammy skin, cool extremities

Front 16

Acute Cholecystitis

Back 16

auscultate, percuss, and palpate the abdomen for tenderness; bowel sounds may be active or decreased, tympany may increase with ileus, there may be RUQ tenderness

Front 17

Stomach Cancer

Back 17

difficult to detect on physical examination, associated with epigastric distress, abdominal fullness, anorexia, and weight loss. In late stages, patients may have ascites, palpable liver mass, and lymph node enlargement

Front 18

Colon Cancer

Back 18

occurs most frequently in the descending and sigmoid colon and rectal areas. Patients report changes in bowel habits, blood in stool, and smaller diameter in bowel movements. Pain may accompany late stages of rectal cancer, a palpable mass may be found of the rectal examination or deep palpation of the LLQ

Front 19

Constipation

Back 19

results from delayed movement of feces through the feces

Front 20

Diverticulitis

Back 20

common outpouchings of the walls of the intestine in which feces may get trapped, causing inflammation, possible infection, abscess, and perforation