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31 Cards in this Set
- Front
- Back
Abnormal findings when performing light palpation on the abdomen... |
-Muscle guarding
-Rigidity -Large Masses -Tenderness |
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Voluntary Guarding occurs...
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-When the person is cold, tense, ticklish.
-Bilateral -Muscles relax on exhalation -Use relaxation techniques |
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Involuntary Rigidity is...
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-Constant boardlike hardness of muscles
-May be unilateral -Accompanying actue inflammation of peritoneum -Area becomes painful during situp |
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Normally palpable structures in abdomen are...
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-Xiphoid process
-Normal Liver edge -Right kidney, lower pole -Pulsatile aorta -Rectus muscles, lateral borders -Sacral Promontory -Cecum, ascending colon -Sigmoid colon -Uterus (gravid) -Full Bladder |
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Tenderness occurs with...
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-Local inflammation
-Inflammation of the peritoneum or underlying organ -Enlarged organ whose capsule is stretched |
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Mild tenderness is normally present when palpating this structure...
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-Sigmoid colon
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If you identify a mass, and distinguish it from a normally palpable structure or an enlarged organ, what 8 qualities would you note
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1) Location
2) Size 3) Shape 4) Consistency (soft, firm, hard) 5) Surface (smooth, nodular) 6) Mobility (including movement with respirations) 7) Pulsality 8) Tenderness |
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To palpate the liver you...
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-Stand on right side of client
-Place left hand under clients 11th and 12th ribs and lift up -Place right hand parallel to midline in RUQ -Push deeply down under right costal margin -Ask client to take deep breath -Should feel edge of liver bump fingertips -Often liver is not palpable OR -Use Hooking technique, hook fingers over right costal margin from above -Ask person to take deep breath |
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To palpate the Spleen...
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-Stand on rigth side of client
-Place Left hand under left side of client body and lift -Place right hand obliquely on LUQ with fingers pointing towards left axilla and just inferior to the rib margin -Push hand deeply down an under left costal margin -Ask client to take deep breath -Should feel nothing unless spleen enlarged |
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The spleen enlarges with...
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-Mononucleosis
-trauma -Do not palpate further if noticed, can rupture -refer client |
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To palpate right kidney...
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-Place your hands duck-bill position at persons right flank
-Use deep palpation and press hands together -Ask client to take deep breath -Occasionally feel lower pole of right kidney as a round, smooth mass |
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To palpate left kidney...
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- Place left hand across abdomen and under left flank for support
-Push right hand deep into abdomen -Ask client to breathe deeply -Should feel nothing as kidney sits 1 cm higher |
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Abnormal findings when palpating the kidneys are...
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-Enlarged Kidney
-kidney mass |
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To palpate aorta...
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-using opposing thumb and fingers
-palpate slightly left of midline in upper abdomen -usually 2.5 - 4 cm wide |
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Blumberg`s sign is also known as...
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-Rebound Tenderness
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Rebound tenderness is done by...
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-You note tenderness during palpation or person reports tenderness
-Placing hand perpendicular to abdomen away from painful area -Push down slowly and deeply -Lift up quickly -Normal response is no pain -Perform test at end of examination -Pain on release is reliable sign of peritoneal inflammation, which accompanies appendicitis |
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Murphy`s sign signifies...
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-Inflammation of gallbladder (cholecystitis)
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When do you perform the iliopsoas muscle test
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-When acute abdominal pain of appendicitis is suspected
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How do you perform iliopsoas muscle test
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-Place client supine
-Lift right leg straight up, flexing at the hip -Push down over the lower part of the thigh as the client tries to hold up leg -Test is negative when no change is felt -Test is positive if pain felt in RLQ, due to inflamed iliopsoas muscle from inflamed or ruptured appendix |
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Abdominal Checklist
INSPECTION |
-Contour
-Symmetry -Umbilicus -Skin -Pulsation or mevment -Hair distribution -Demeanour |
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Abdominal Checklist
AUSCULATION |
-Bowel sounds
-Note any vascualr sounds |
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Abdominal Checklist
PERCUSSION |
-Percuss all four quadrants
-Percuss borders of liver, spleen |
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Abdominal Checklist
PALPATION |
-Light palpation in all four quadrants
-Deep palpation in all four quadrants -Palpate for liver, spleen, kidneys |
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Abnormalities on Palpation of Enlarged Organs
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-Enlarged liver
-Enlarged nodular liver -Enlarged gallbladder -Enlarged spleen -Enlarged kidney -Aortic aneurysm |
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Except with a depressed diaphragm, a liver palpated more than 1 - 2 cm below costal margin is considered...
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-Enlarged
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The iliopsoas muscle test and Obturator test are used to determine if the client has...
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-Appendicitis
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Diastasis recti is...
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-A seperation of the rectus muscles with a visible bulge along midline
-Common in infants of African decent -refer client if lasts more than 6 years |
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Infant Inspection yields...
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-Protuberant contour
-Fine, superficial venous pattern -respiratory movement -Possible peristalsis |
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Infant Ausculation yields...
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-bowel sounds
-No vascular sounds should be heard |
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The seven f's of Abdominal Distension...
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-fat
-flatus -fluid -fetus -feces -fetal growth -fibroid |
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Peritoneal Friction Rub...
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-A rough, grating sound, like two pieces of leather rubbed together, indicates peritoneal inflammation
-Occurs rarely, usually over organs with large surface area in contact with the peritoneum |