With Complete Solutions
HPI questions for chief complaint of abdominal issue correct
answer: ○Abdominal pain-OLDCARTS
○When did the pain start?
○Where is the pain in your stomach?
○Does the pain radiate to other locations?
○Have experience nausea/vomiting, indigestion or increase in
belching.
○What medications have you used to treat your symptoms?
○Have you had any diarrhea or constipation?
○Do you have to use laxative frequently?
○What is your regular dietary habits?
inspection of abdomen correct answer: -Abdominal contour
-Symmetry
-Umbilicus
-Skin Color
-Vascularity
-Scars
-Striae
-Lesions or rashes
-Abdominal movement when breathing
-Aortic pulsation
-Have patient raise head while laying down and look for masses
hernia or muscle separation
,Abdominal assessment order correct answer: inspection,
auscultation, percussion, palpation
Always auscultate prior to percussion and palpation as it can
change sound.
Abdomen Auscultation correct answer: Bowel sounds in all
four quadrants- note frequency and character
listen for friction rubs over liver and spleen
listen for bruits over the aortic, renal, illiac and femoral arteries
listen for venous hum around epigastric area above the belly
button
Abdominal findings abdomen correct answer: ○Bruits- A
swishing sound heard over the aortic, renal iliac, and femoral
arteries, indicating narrowing or aneurysm.
○Pop/Tinkles- High pitch sound suggesting intestinal fluid and
air under pressure, as in early obstruction.
○Rushes- Rushes of high-pitched sounds that coincide with
cramping suggests intestinal obstruction.
○Borborygmi- Increased prolonged gurgles occur with
gastroenteritis, early intestinal obstruction, and hunger.
, ○Rubs- Grating sounds that vary with respiration. Indicate
inflammation of the peritoneal surface of an organ from tumor,
infection, or splenic infarct.
○Venous Hum- A soft humming noise often heard in hepatic
cirrhosis that is caused by increased collateral circulation
between portal and systemic venous system.
○Succussion splash- A splashing noise produced by shaking the
body when there is both gas and fluid in a cavity or free air in
the peritoneum or thorax.
○Decreased/absent bowel sounds- Occurs with peritonitis or
paralytic ileus.
How to percuss to estimate the liver span correct answer: o
First, determine the lower border of the liver by percussing up
from an area of tympany along the right midclavicular line.
Mark the point where tympany changes to dullness, which
usually occurs at or slightly below the costal margin.
o Second, determine the upper border of the liver by percussing
down from an area of resonance along the right midclavicular
line. Mark the point where resonance changes to dullness, which
usually is in the fifth intercostal space.
o Third, measure the distance between the marks. The vertical
liver span usually ranges from 6 to 12 cm.
Blumberg Sign correct answer: Rebound tenderness, RLQ,
appendicitis, peritoneal irritation