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Umbilical cord
2 arteries and one vein
liver in infants/children
takes up more space in abdomen at birth
lower edge palpated 0.5-2.5 cm
bladder in infants/children
higher in abdomen than adults
pregnancy abdominal changes
visible striae
n/v
pregnancy progesterone
causes relaxation of esophageal sphincter and alters gastric tone (heartburn)
constipation
gallbladder is sluggish (sludge or stones)
pregnancy stomach and intestinal displacement
bowel sounds diminished
appendix in RUQ
decreased intestinal motility
aging adult abdominal changes
fat accumulates
salivation decrease
decreased taste
,delayed esophageal emptying
gastric secretions decrease
gastric emptying decreases
slowed intestinal motility
gallstones
liver in aging adults
decreased size
loss of ability to metabolize drugs
common causes of abdominal pain
◦Fat
◦Fluid
◦Feces
◦Fetus
◦Fibroid
◦Full bladder
◦False pregnancy
◦Fatal tumor
◦Flatus
cutaneous hypersensitivity
exaggerated pain response to stimuli
indicates peritoneal inflammation
referred pain pancreatitis
l shoulder
lumbar back
referred pain penetrating duodenal ulcer
r posterior axilla
r posterior thoracic (T9)
r hypochondria and epigastric
, abdominal physical exam
RLQ
RUQ
LUQ
LLQ
Cullen's sign
bluish or purple discoloration around umbilicus
Indicates intra-abdominal bleeding
Grey Turner's sign
Brusing of the flank
Retroperitoneal hemorrhage
jaundice causes during bilirubin production or excretion
Hep A/B/C
alcohol
autoimmune
genetic defects
medicines
jaundice after bilirubin is produced
gallstones
gallbladder swelling/cancer
pancreatic tumor
Hypercarotenemia
a condition caused by the accumulation of carotenoids in the adipose tissue,
causing the skin to appear yellow-orange
skin in forehead, around alae nasi, palms, soles
sclera not stained