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12 Cards in this Set

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Abdominal paradox
weakness of diaphragm, becomes passive membrane. Ex. Abd expands while chest pulled inward. Predicts resp failure
Respiratory alterans
alternate use of diaphragm or intercostals resp muscles. Pts cycle from resp alterans to abd paradox. Indicates resp failure
Striae
cushings (purple and multiple), pregnancy, wt gain
Abdomino jugular reflex used to
unmask subclinical CHF
Murphy’s sign
used to dx acute cholecystitis. Press toward pt’s head, have pt take deep breath
Courvoisier’s law
stiff gall bladder likely to indicate gb cancer
Acute abdomen 3 maneuvers in exam
1. Guarding/ (involuntary)rigidity 2. Abd wall tenderness 3. Rebound tenderness
Carnett’s sign
differentiate abd wall inflam vs viscus inflam. Palpate tenderness, have pt raise head to tense abd muscles, ask if there is change in pain
Abdominal hyperesthesia
hypersensitivity to light touch (herpes zoster)
5 tests for appendicitis
1.mcburny’s sign 2. Rovsing’s sign (pain in rt iliac fossa by pressing on LLQ) 3.obturator test (pain around ob) 4.reverse psoas maneuver (pain around ps) 5. Rectal tenderness
None
ascites unlikely if pt has no hx
1. Increased abdominal girth 2. Ankle edema (best to rule in/out)
4 physical exam techniques for ascites
1.bulging flanks ABSENCE RULES OUT (obese) 2. Percussion for flank dullness (rounded area of tympani (floating intestines) 3. Shifting dullness (gravity dependent shift in dullness from supine to 45 deg = fluid) 4. Fluid wave test BEST TO RULE IN (hand on one flank, tap on other, feel for wave)