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Study Guide

Assessing the Abdomen


READ CAREFULLY:

  1. Taylor, Lillis, & LeMone, Chapter 25 (pp. 486 - 488)
  2. Bickley, Chapter 9 (pp. 317 - 366)
  3. Class lecture notes off the Internet

TERMS TO KNOW:

  1. Ascites
    1. accumulation of serous fluid in the peritoneal cavity
  2. Blumberg's sign
    1. occurance of sharp acute pain when an examiner presses his or her hand over McBurney's point and then releases the hand pressure suddently; sign of possible peritonitis
  3. Borborygmus
    1. a gurgling, splashing sound normally heard over the large intestine; "stomach growling"
  4. Bruits
    1. a pulsatile, whooshing, or blowing sound caused by accelerated or turbulent blood flow
  5. Costovertebral angle
    1. the angle between the 12th rib and the vertebral column
  6. Cullen's sign
    1. bluish discoloration of the umbilicus; sign of possible intra-abdominal hemorrhage
  7. Friction rub
    1. the distinct sound heard when two dry surfaces are rubbed together
  8. Hepatomegaly
    1. enlargement of the liver
  9. Involuntary rigidity
    1. constant, boardlike hardness of the abdominal muscles that accompanies acute inflammation of the peritoneum (e.g., peritonitis, appendicitis)
  10. Peritonitis
    1. inflammation of the serous membrane that lines the abdominal cavity and its viscera (peritoneal cavity)
  11. Splenomegaly
    1. enlargement of the spleen
  12. Striae
    1. silver-white line seen in parts of the body where the skin has been stretched
  13. Voluntary rigidity
    1. abdominal muscle rigidity that occurs when a patient is cold, tense, or ticklish which usually relaxes during exhalation

LEARNING ACTIVITIES:

  1. Lecture
  2. Discussion
  3. Read the following PRIOR to class:
    1. Taylor, Lillis, & LeMone, Chapter 25 (pp. 486 - 488)
    2. Bickley, Chapter 9 (pp. 317 - 366)
    3. Class lecture notes off the Internet

STUDY QUESTIONS TO REVIEW FOR TEST:

  1. Purposes of assessing the abdomen.
  2. Function of the abdomen.
  3. Structures of the abdomen.
  4. Pertinent history related to assessing the abdomen.
  5. Correct technique for inspecting the skin over the abdomen, inspecting the umbilicus, inspecting the contour (shape) of the abdomen, inspecting the abdomen for symmetry, bulges, or masses, inspecting the abdomen for pulsations and/or movements, auscultating the abdomen, auscultating the abdomen for bruits, auscultating the abdomen for a friction rub over the liver, auscultating the abdomen for a friction rub over the spleen, percussing the abdomen for prevailing tympany and dullness, percussing the abdomen to determine the vertical span or height of the liver, performing the scratch test to determine the lower border of liver dullness (when the abdomen is distended or the abdominal muscles are tense), percussing the liver for tenders (if the liver is unpalpable), percussing the liver for splenic dullness, percussing the abdomen for the splenic percussion sign (if splenomegaly is suspected), lightly palpating the abdomen, deeply palpating the abdomen, palpating the abdomen for rebound tenderness (Blumberg's sign), palpating the liver, palpating the spleen, palpating the right kidney, palpating the left kidney, palpating the aorta, testing for Rovsing's sign (if appendicitis is suspected), performing the iliospoas muscle test (if appendicitis is suspected), performing the obturator test (if appendicitis is suspected), testing for tenderness in the costovertebral angle, testing for inspiratory arrest (Murphy's sign) (if acute cholecystitis is suspected), testing for a fluid wave (if ascites is suspected), testing for shifting dullness (if ascites is suspected).
  6. Normal findings obtained from inspecting the skin over the abdomen, inspecting the umbilicus, inspecting the contour (shape) of the abdomen, inspecting the abdomen for symmetry, bulges, or masses, inspecting the abdomen for pulsations and/or movements, auscultating the abdomen, auscultating the abdomen for bruits, auscultating the abdomen for a friction rub over the liver, auscultating the abdomen for a friction rub over the spleen, percussing the abdomen for prevailing tympany and dullness, percussing the abdomen to determine the vertical span or height of the liver, performing the scratch test to determine the lower border of liver dullness (when the abdomen is distended or the abdominal muscles are tense), percussing the liver for tenders (if the liver is unpalpable), percussing the liver for splenic dullness, percussing the abdomen for the splenic percussion sign (if splenomegaly is suspected), lightly palpating the abdomen, deeply palpating the abdomen, palpating the abdomen for rebound tenderness (Blumberg's sign), palpating the liver, palpating the spleen, palpating the right kidney, palpating the left kidney, palpating the aorta, testing for Rovsing's sign (if appendicitis is suspected), performing the iliospoas muscle test (if appendicitis is suspected), performing the obturator test (if appendicitis is suspected), testing for tenderness in the costovertebral angle, testing for inspiratory arrest (Murphy's sign) (if acute cholecystitis is suspected), testing for a fluid wave (if ascites is suspected), testing for shifting dullness (if ascites is suspected).
  7. Implications of variations from normal findings obtained from inspecting the skin over the abdomen, inspecting the umbilicus, inspecting the contour (shape) of the abdomen, inspecting the abdomen for symmetry, bulges, or masses, inspecting the abdomen for pulsations and/or movements, auscultating the abdomen, auscultating the abdomen for bruits, auscultating the abdomen for a friction rub over the liver, auscultating the abdomen for a friction rub over the spleen, percussing the abdomen for prevailing tympany and dullness, percussing the abdomen to determine the vertical span or height of the liver, performing the scratch test to determine the lower border of liver dullness (when the abdomen is distended or the abdominal muscles are tense), percussing the liver for tenders (if the liver is unpalpable), percussing the liver for splenic dullness, percussing the abdomen for the splenic percussion sign (if splenomegaly is suspected), lightly palpating the abdomen, deeply palpating the abdomen, palpating the abdomen for rebound tenderness (Blumberg's sign), palpating the liver, palpating the spleen, palpating the right kidney, palpating the left kidney, palpating the aorta, testing for Rovsing's sign (if appendicitis is suspected), performing the iliospoas muscle test (if appendicitis is suspected), performing the obturator test (if appendicitis is suspected), testing for tenderness in the costovertebral angle, testing for inspiratory arrest (Murphy's sign) (if acute cholecystitis is suspected), testing for a fluid wave (if ascites is suspected), testing for shifting dullness (if ascites is suspected).

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This page was last modified on 1/1/03