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86 Cards in this Set
- Front
- Back
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3 general divisions of abdomen?
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Epig
Mesog Hypogastrium + Hypochondrium Or in quadrants |
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Swelling in right hypochondrium?
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Hepatomegaly or gall bladder swelling
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Swelling in left hypochondrium?
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Splenomegaly
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Where may we find collateral venous circulation in obstruction of portal system?
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Esophageal collaterals
Hypogastric collaterals Rectal collaterals |
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What is caput medusae?
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Dilated veins around the umbilicus (due to portal system obstruction?)
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How to distinguish between caput medusae and IVC obstruction?
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Caput medusae: Blood flow --> Legs
IVC obstruction: Blood flow --> Head |
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In IVC obstruction - what veins also become dilated?
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Lateral abdominal veins
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What is a midline laparotomy?
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Midline cut in surgery. Upper = Stomach. Lower = Gynecological in female
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Where may we find pigmentations in Addison´s disease?
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On wasteline & linea alba
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Where may we find pigmentations following radiation therapy of genital cancer in women?
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Hypogastrium, accompanied by telangiectases
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What are striae?
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Irregular skin fissures due to:
- Rapid fat accumulation - Enlargement of the abdomen |
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What type of striae are found in Cushings disease?
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Purple
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What is diastasis?
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A disorder where right and left side of rectus abdominis separate - giving increased risk of hernias
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What is meteorism / tympanites?
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Accumulation of gas in GIT
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What is pneumoperitoneum?
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Air or gas present in abdominal cavity
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What is ascites?
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Presence of free fluid in abdominal cavity
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What is ballottement?
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PE technique where one pushed kidney from behind and palpate abdominal wall to find floating kidney
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What is guarding?
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Local rigidity of the abdominal muscles. If painful it may mean peritoneal irritation
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What may guarding be a sign of?
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Appendicitis
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What is Blumberg´s sign?
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A "rebound tenderness". When hand pushed in abdomen, and removed suddenly, there is pain developed quickly.
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What is Blumberg´s sign a sign of?
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Peritoneal inflammation
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How is palpable findings in acute pancreatisis?
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Extremely painful but abdominal wall may remain soft (no guarding)
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Where is guarding typical in acute appendicitis?
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At McBurney´s point
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What is Rovsing´s sign?
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Guarding at McBurney´s point in acute appendicitis
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Dull tenderness and pain in stomach area may indicate?
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Acute dyspepsia
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What is borborygmi?
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Rumbling stomach
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Movable on palpation tumors of intestine usually occur in which part?
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Transverse colon
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Tumors of intestine following breathing motion usually rise in?
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Hepatic and splenic flexure
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A pulsating mass behind navel may indicate?
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Aneurysm of abdominal aorta
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Physiological percussion sound of abdomen?
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Tympany
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Dullness of abdominal percussion may mean?
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Tumors or ascites
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Pain during percussion means?
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Acute abdomen
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Auscultatory signs of hyperperistalsis?
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Borborygmi
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Auscultatory signs of paralytic ileus?
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Silence
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How to assess the size of the liver?
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Scratch downwards with stethoscope placed on xiphoid process
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Description of location of pathological findings in rectal examination is done how?
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Clock dial - 12 o clock is coccyx
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What is dysphagia?
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Difficulties with swallowing
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Most common causes of dysphagia in patients <40y?
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Peptic esophagitis
Achalasia |
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Most common causes of dysphagia in patients >40y?
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Cancer
Peptic esophagitis |
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What is odynophagia?
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Pain on deglutition
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What is deglutition?
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The act of swallowing
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Cause of odynophagia?
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Usually inflammation or ulcers of the mucosa
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What is pyrosis?
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Heartburn - reflux
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Cause of pyrosis?
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Usually hiatal hernia
Pregnancy |
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What is dyspepsia?
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Indigestion - disturbances of digestion
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What is ructus / belching?
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Burping
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What is emesis?
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Vomitus
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What is halitosis?
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Bad breath
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What is singultus?
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Hiccups
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What is ruminatino?
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Teeth grinding
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What is merycism?
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Teeth grinding perceived as pleasant
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What type of painful stimuli is the GIT insensitive to?
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Stabbing or cutting.
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2 types of abdominal pains?
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1. Somatic epicritic pain
2. Visceral protopathic pain |
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How is the somatic epicritic pain?
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Localized
Sharp Acute |
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How is the visceral protopathic pain?
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Diffuse
Blunt Slowly developing |
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What is colic?
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Severe undulant spatic pain, usually 3 minutes painful and 3 minutes not painful, repeating
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In peptic ulcers, how long time after food occurs pain?
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Within 1 hour
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In duodenal ulcers, how long time after food occurs pain?
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Over 2 hours
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Symptoms of visceral pain syndrome?
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Dull pain, localized in midline, with vomiting / diarrhea
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Usual causes of purely visceral pain syndrome?
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Uncomplicated gastric ulcers
Gallbladder diseases |
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How is visceral pain syndrome with transmitted pain?
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Continuous with radiation that may be diagnostically important
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Possible causes for visceral pain syndrome with spreading?
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Penetration of gastric ulcer
Inflammation of the wall of diseased organ Gallstone with mucosal irritation |
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Biliary diseases pain spreads to?
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Right hypochondrium & right scapula
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Pain from tail of pancreas and ulcers of posterior stomach wall usually radiates to?
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Left hypochondrium and left scapula
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A gallbladder colic pain develops typically after?
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Several hours after FATTY meal, often at night
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What provokes pain in pancreatitis?
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Meals (fat and proteins)
Palpations of abdomen |
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Heartburn is often caused by?
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Sweets and pastry
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What is the Jack-knife phenomenon?
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When patient press the fist to painful area
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Typical cholecystitis pain?
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Spreading to right hypochondrium and right scapula
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What is aerophagia?
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Increased swallowing of air
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Cause of aerophagia?
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- Neurotics
- Achalasia - Hiatal hernia |
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What is achalasia?
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Failure of smooth muscle fibers to relax
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Increased gas / flatulence usually comes from?
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1. Aerophagia
2. Increased diffusion of blood gases to intestine due to venous congestion 3. Increased fermentation and putrefaction by intestinal bacteria |
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What is hematemesis?
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Vomiting of blood
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Hematemesis usually comes from?
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Rupture of esophageal varices
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What is melena?
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Digested blood in feces
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How much bleeding must there be to document melena?
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50-100ml
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What is hematochezia / enterorrhagia?
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Fecal fresh blood originating from lower GIT
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Where does melena blood usually originate?
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Upper GIT
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Hematochezia / enterorrhagia is common in?
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- Hemorrhoids
- Hemorrhagic proctitis - Ulcerative colitis - Non stenosing rectal tumors |
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What test is done for documenting microscopical fecal bleeding?
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Benzidine test
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Chronic bleeding may lead to?
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Iron deficiency and sideropenic anemia
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What is steatorrhea?
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Presence of fat in the stools, related to fat malabsorption
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What is acholia?
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Absence of fecal bile pigments - give white or gray stools
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What is achlorhydria?
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Very low or no production of gastric acid, give increased passage of undigested foods
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What is "undulation" in ascites examination?
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Fluid wave generated when tapping on one side and holding on other side, with a 3rd hand stabilizing on top
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