Abdomen Physical Exam – Bates (Questions & Answers) Rated 100% Correct!!

A protuberant abdomen that is tympanic throughout suggests what? - intestinal obstruction After screening, what should be done in the follow up of possible abdominal arotic aneurism? - Palpation followed by ultrasound decreases mortality, especially in male smokers >65 years old. Ascites can occur as a result of what two pathological processes? - 1. increased hydrostatic pressure (cirrhosis, heart failure, constrictive peridcarditis, IVC or hepatic vein obstruction) 2. Decreased oncotic pressure (nephrotic syndrome or ovarian cancer) Besides McBurney's point rebound tenderness, name some other signs associated with appendicitis. - Rovsing's sign, psoas sign, obturator sign Besides splenic enlargement, when could you also get a splenic percussion sign? - Normal sized spleen (b/c of anatomic location) Besides the anterior abdominal region, where else should we listen for the presence of epigastric bruits? - costovertebral angles Bladder infection can commonly present with what symptom? - suprapubic tenderness Bruits are suggestive of what? - Vascular occlusive disease Bruits with both systolic and diastolic components are most likely the result of what pathological process? - atherosclerotic arterial disease Bulging flanks are suggest what? - ascites Describe location of spleen - Lateral to and behind the stomach, just above left kidney(in midaxillary line) Describe normal bowel sounds. - clicks/gurgles (5-34 per minute) Describe the classic presentation of appendicitis. - Pain begins near umbilicus, the shifts to right lower quadrant (coughing increases the pain). Younger people are more likely to report this. Dilated veins can indicate what 2 general pathologies? - Hepatic Cirrhosis or IVC obstruction Dullness in both flanks suggests what? - Ascites Echymosis of the abdominal wall is indicative of what? - Intraperitoneal or retroperitoneal hemorrhage Examiners with a heavier percussion strike ____________ liver size? - Underestimate Friction rubs over liver and/or spleen are suggestive of what? - Pancreatic carcinoma Gas in the colon that produces tympany in the right upper quadrant could do what? - obscure liver dullness, and falsely decrease estimation of liver size How can one distinguish between palpation of the right kidney and the liver? - The lower pole of the kidney is rounded, but the liver is a sharper and extends much farther medially How can we reduce exam complications due to an excessively ticklish patient? - Start palpations with patient's hand under yours... then slip your hand underneath to palpate directly How can you differentiate an abdominal wall mass from an intra-abdominal mass? - Valsalva causes muscular contraction--> intra-abdominal mass will become obscured by contraction, and an abdominal wall mass will stay the same.How can you exacerbate a hernia? - Valsalva How do you assess the integrity of sacral nerves that innervate the bladder? - Perirectal and perineal sensation in S2, S3, S4 dermatomes.