Summary NSG6020 WEEK 5 ABDOMEN STUDY GUIDE (LATEST, 2022/2023) SOUTH UNIVERSITY

NSG6020 WEEK 5 ABDOMEN STUDY GUIDE I I I I I I




Four quadrants of the abdomen: right upper, right lower, left upper, and left
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lower quadrants
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Location dividing the abdomen into 4 sections: Umbilicus
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The lower margin of the liver can be palpated at the right costal margin.
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The Lower edge of the liver and the Right kidney are usually palpable.
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What quadrant is the spleen palpable in? Left upper quadrant
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The Abdominal aorta often has visible pulsations and is usually palpable in
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the upper abdomen.
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You can often feel the firm, narrow, tubular sigmoid colon in what quadrant?
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Left Lower quadrant
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Appendix & bowel loops of RLQ are normally not palpable in healthy adults
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Bladder distention may be palpable above the symphysis pubis.
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Upper gastrointestinal symptoms may include abdominal pain, heartburn,
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nausea and vomiting, difficulty or pain with swallowing, vomiting of stomach
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contents or blood, loss of appetite, and jaundice.
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Three broad categories of pain: visceral, parietal, and referred.
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Visceral pain occurs when hollow abdominal organs such as the intestine or
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biliary tree contract unusually forcefully or are distended or stretched.
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Visceral pain in the right upper quadrant may result from liver distention.
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Visceral pain quality varies in quality and may be gnawing, burning,
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cramping, or aching. When it becomes severe, it may be associated with
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sweating, pallor, nausea, vomiting, and restlessness.
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Pain from pleurisy or inferior wall myocardial infarction may be referred to
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epigastric area.
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Pain of duodenal or pancreatic origin may be referred to the back.
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Pain from the biliary tree may refer to right shoulder or the right posterior
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chest.
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Characteristic of pain: Timing ~chronic ~intermittent ~continuous I I I I I I


Doubling over with cramping colicky pain indicates: Renal Stone
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, Epigastric pain occurs with Gastritis & GERD. I I I I I I


Right upper quadrant and upper abdominal pain are common in
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Cholecystitis.
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Angina from inferior wall coronary artery disease may present as indigestion
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but is precipitated by exertion and relieved by rest.
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Bloating may occur with inflammatory bowel disease. I I I I I I


Belching is caused by aerophagia or swallowing air. I I I I I I I


Defined as a 3-month history of nonspecific upper abdominal discomfort or
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nausea not attributable to structural abnormalities or peptic ulcer disease
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are: functional, or nonulcer, dyspepsia
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If patient complain of heartburn, acid reflux, regugitation for more than once a
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week, they are likely to have? GERD until proven otherwise
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Risk factors for GERD: reduced salivary flow which prolongs acid clearance
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by damping action of bicarb, delayed gastric emptying, some meds, and
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hiatal hernia
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Heartburn is a rising retrosternal burning pain or discomfort occurring weekly
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or more often. Heartburn is typically aggravated by food.
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Angina from the inferior wall coronary ischemia along the diaphragm may
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present as heartburn.
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Atypical respiratory symptoms of GERD: coughing, wheezing, and aspiration
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pneumonia.
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GERD: alarm symptoms: Weight loss. Recurrent vomiting, Evidence of GI
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bleeding or anemia, Dysphagia (difficulty swallowing), and Odynophagia
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(painful swallowing).
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What GERD patients warrant endoscopy? Uncomplicated GERD non-
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responsive to empiric therapy, alarm symptoms, and patients >55yo. I I I I I I I I


Acute appendicitis is right lower quadrant pain or pain that migrates from the
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periumbilical region with abdominal wall rigidity on palpation.
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In women, appendix area pain may indicate pelvic inflammatory disease,
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ruptured ovarian follicle, and ectopic pregnancy.
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Cramping pain radiating to the RLQ or LLQ may be a renal stone. I I I I I I I I I I I I I



Left lower quadrant pain with a palpable mass may be:Diverticulitis
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