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94 Cards in this Set
- Front
- Back
how much can the bladder hold
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300 ml, max of 400-500 ml
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what are the smooth muscle of the bladder called
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detrusor muscle
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what thrusts abdomen forward and tightens abdominal musclesq
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arched back
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pink-purple striae are seen in
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Cushing's syndrome
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dilated veins are seen in
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hepatic cirrhosis and IVC obstruction
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bulging flanks are seen in
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ascites
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asymmetry is caused by
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enlarged organ or mass
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increased perstaltic waves are seen in
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intestinal obstruction
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increased pulsation of epigastrium in
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aortic aneurysm or increased pulse pressure
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in the abdomen exam, what do you do after inspect
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auscultate
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bowel sounds may be altered in...
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diarrhea, intestinal obstruction, paralytic ileum and peritonitis
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what is borborygmi
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stomach growling/hyperperistalsis
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what is normal frequency of bowel sounds
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5-34 per min.
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a bruit that is systolic and diastolic in the upper abdomen strongly suggests..
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renal artery stenosis as cause of hypertension
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bruits with both systolic and diastolic components in lower abdomen suggest
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turbulent blood flow of partial arterial occlusion or arterial insufficiency
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friction rubs are seen in
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liver tumor
gonococcal infections splenic infarction |
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what percussion note is dominant in the abdomen
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tympany, some dullness from poop
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a protuberant belly that is tympanic throughout suggests
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intestinal obstruction
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large dull areas of underlying masses could be from
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pregnant uterus, ovarian tumor, distended bladder, large liver or spleen
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dullness in both flanks indicates
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further assessment for ascites
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involuntary rigidity of the abdomen indicates
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peritoneal inflammation
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abdominal pain when coughing or w/ light percussion suggests
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peritoneal inflammation
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what is rebound tenderness
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pain caused by rapid movement of an inflamed peritoneum
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rebound tenderness suggests
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peritoneal inflammation
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liver dullness may be displaced downward by
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low diaphragm of COPD but span remains normal
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what are the normal sizes of liver dullness
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4-8 cm midsternal, 6-12 midclavicular
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dullness of right pleural effusion or consolidated lung may falsely ____ liver dullness area
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increase
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gas in colon may produce tympany and falsely _____ estimate of liver size
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decrease
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firmness/hardness of liver and rounding/bluntness of its edge suggest
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abnormality of liver
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tenderness of the liver suggests
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inflammation, as in hepatitis or congestion as in heart failure
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traubes space is associated with
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locating the spleen
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a positive splenic percussion sign is
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a change in percussion note from tympany to dullness on inspiration
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t/f splenic percussion sign may be positive when spleen size is normal
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true
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a palpable spleen tip may indicate
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splenic enlargement, but not always
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the enlarged spleen is palpable about ___cm below left costal margin on insp.
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2
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causes of kidney enlargment are
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hydronephrosis, cysts, and tumors
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bilateral kidney enlargement suggests..
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polycystic kidney disease
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pain with pressure or fist percussion at the CVA suggests
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pyelonephritis but may have musculoskeletal origin
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bladder distention can be from
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outlet obstruction due to urethral stricture, prostatic hyperplasia also from meds and stroke, MS
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in an older person, a periumbilical or upper abdominal mass with expansile pulsations suggests
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aortic aneurysm
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it may be hard to distinguish a tortuous aorta from ____ clinically
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aortic aneurysm
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t/f anuerysms are usually painless until they rupture
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true
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should you get an ultrasound of an enlarged aorta
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yes
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in ascites, dullness shifts to
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the dependent side and tympany shifts to the top
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the fluid wave test is for _____ and an easily palpable impulse suggests _____
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ascites
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the pain of appendicitis classically begins near the ____ then shifts to the _____
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umbilicus; lower right quadrant
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localized tenderness anywhere in the right lower quadrant may indicate ..
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appendicitis
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involuntary muscle rigidity may be seen in
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appendicitis
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right sided rectal tenderness may be caused by _____ and ____ as well as by inflamed appendix
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inflamed adnexa; inflamed seminal vesicle
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rebound tenderness suggest _____ as in appendicitis
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inflamed peritoneum
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pain in right lower quadrant during left-sided pressure is a positive ______ sign and suggests
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Rovsings; appendicitis
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increased abdominal pain in thigh flexion or extension is a postive ____ sign and suggests___
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psoas; appendicitis
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right hypogastric pain during internal rotation of the thigh is a positive ____ suggesting ___
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obturator; appendicitis
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cutaneous hyperesthesia is _____ and is seen in ____
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pain upon picking up skin of abdomen; appendicitis
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what is murphys sign
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hooking your finger under the costal margin to check for cholecystitis
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a positive murphys sign is
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a sharp increase in tenderness and sudden stop in insp. effort, it's positive for acute cholecystitis
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what is a ventral hernia and how do you find it
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an abdominal hernia that is not in the groin; ask the pt to raise head and shoulder off table
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a mass in the abdominal wall remains _____ while an intra-abdominal mass is obscured by muscular contraction
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palpable
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umbilical hernia
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a protrusion through a defective umbilical ring, common in infants and usually closes spontaneously
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incisional hernia
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protrusion through an operative scar
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diastasis recti
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separation of the 2 recti muscles through which abdominal contents form a midline ridge with raised head and shoulders
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diastasis recti is commonly seen in
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repeated pregnancies, obesity, and chronic lung disease. has no clinical consequences
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lipoma
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common, benign, fatty tumors in subcut tissues of anywhere on body
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if you push on a lipoma, will it be firm or mobile
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mobile
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serious causes of gas include
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intestinal obstruction and adynamic (paralytic) ileus.
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gas distention is ____ marked in colonic than in small bowel obstruction
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more
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an abdominal tumor is ____ to percussion
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dull
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occasionally a distended bladder may be mistaken for a _____
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tumor
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bowel sounds may be increased by
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diarrhea or early intestinal obstruction
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bowel sounds may be decreased/absent by
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adynamic ileus and peritonitis
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how long should you listen before deciding bowel sounds are absent
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2 min
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high-pitched tinkling bowel sounds suggest
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intestinal fluid and air under tension in dilated bowel
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rushes of high-pitched sounds that coincide with abdominal cramp indicate
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intestinal obstruction
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a hepatic bruit suggests
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carcinoma of the liver or alcholic hepatitis
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venous hum is
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a soft humming noise w/ both systolic and diastoic components
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venous hum indicates
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increased collateral circulation between portal and systemic venous systems, as in hepatic cirrhosis
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friction rubs are
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grating sounds with respiratory variation
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friction rubs indicate
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inflammation of peritoneal surface of an organ, as in liver tumor, chlamydial or gonococcal perihepatitis, recent liver biopsy or splenic infarct
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systolic bruit + hepatic friction rub =
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carcinoma of the liver
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abdominal tenderness from a lesion deep to abdominal wall will _____ with flexed abdominal muscles while it _____ with a lesion of the abdominal wall
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decrease; remains
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abdominal pain and tenderness may result from _____ which may mimic cholecystitis or appendicitis
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acute pleurisy
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acute salpingitis is
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inflammation of teh fallopian tubes
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the tenderness of acute salpingitis is maximal where? and motion of uterus causes ____
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above inguinal ligaments; pain
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tenderness from peritoneal inflammation is more ____ than visceral tenderness
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severe
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muscular rigidity and rebound tenderness are frequently associated with
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peritoneal inflammation
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acute cholecystitis tenderness is maximal in
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the upper right quadrant
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what is not normal about acute pancreatitis
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epigastric tenderness and rebound tenderness are present but ab wall may be soft
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acute appendicitis has tenderness...
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in the lower right quadrant, right rectal tenderness as well as right flank
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acute diverticulitis has tenderness over ...
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sigmoid colon and resembles left-sided appendicitis
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in a downward displaced liver, the diaphragm is ____ and the vertical span of the liver is ___
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low; normal
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tall people may have elongated livers with long right lobes also called____. volume and size of liver is ____
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riedel's lobe; normal
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cirrhosis may produce a_____
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enlarged liver with a firm, nontender edge
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an enlarged liver with a smooth tender edge suggests
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inflammation, as in hepatitis, or venous congestion, as in right-sided heart failure
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a irregular large liver that is firm or hard and may or may not be tender suggests
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malignancy
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