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Inside the abdominal cavity all the internal organs are called the viscera.
Liver
Spleen
Pancreas
Adrenal glands
Kidneys
Ovaries
Uterus
Stomach
Gallbladder
Small intestines
Colin
Bladder |
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Subjective data
1. Appetite
2.dysphagia
3.food intolerance
4.abdominal pain
5.nausea/vomiting
6. Bowel habits
7. Past abdominal history
8.medications
9.nutritional assessment |
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| Contour. Describes the nutritional state and normal Ranges from flat to rounded |
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| Scaphoid abdomen caves in |
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| Abdomen bulges out (pregnant belly) |
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| Hernia: a protrusion of abdominal viscera through abnormal opening in the muscle wall |
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Ascites: Free fluid in the peritoneal cavity. May see distended abdomen, bulging flanks, and an umbilicus that is protruding and displaced downward. You can differentiate ascites from gaseous distention by performing two percussion test the fluid wave test and a shifting level of dullness test. Skin glistening and taugh, may have striae
-ascites occurs with heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and cancer
Inspection: Single curved. You Verdet umbilicus. Bulging flanks when supine. Talk, listening skin; recent weight gain; increase in abdominal girth.
Auscultation: Normal bowel sounds over the intestines. Diminished over ascitic fluid.
Percussion: Tympany at top where intestines float. Dull over fluid. Produces fluid wave and shifting dullness
Palpation: taught skin and increased intra-abdominal pressure limit palpation |
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Striae (linea albicantes): So very white, linear, jagged marks about 1-6 cm long. They occur when elastic fibers in the reticular layer of the skin are broken after rapid or prolonged stretching, as in pregnancy or excessive weight gain. Recent striate are pink or blue, they then turn silvery white. May occur with ascites.
- Striae look purple – blue with Cushing's syndrome (excess adrenocorticoid hormone leading to fragile skin and easy breakdown from normal stretching) |
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| Distention: swelling or expansion in all directions |
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| Borborygmus: One type of hyperactive bowel sound that is fairly common, this is the hyper peristalsis you feel when your stomach is growling |
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| Hyperactive sounds: loud, high-pitched, rushing, tinkling sounds that signal increased mobility |
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| Hypo activity or absent sounds |
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| Hypo activity or absent sounds: Follow abdominal surgery or with inflammation of the peritoneum |
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Hepatomegaly: Enlarged liver span
And enlarged, smooth, and nontender liver occurs with fatty infiltration, a portal obstruction or cirrhosis, high obstruction of inferior vena cava, lymphocytic leukemia. The liver feels enlarged and smooth but is tender to palpation with early heart failure, acute hepatitis, hepatic abscess
Enlarged modular liver: And in Larson nodular liver occurs with late portal cirrhosis, metastatic cancer, or tertiary syphilis |
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Splenomegaly: enlargement of the spleen. A dull note forward of the midaxillary line indicates enlargement of the spleen as it occurs in mononucleosis, trauma and infection.
-Because any enlargement superiorly is stopped by the diaphragm, the spleen enlarges down into the midline. When extreme, it can extend down to the left pelvis. It retains splenic notch at the medial edge. When splenomegaly occurs with acute infections such as mononucleosis, it is moderately enlarged and soft, with rounded edges. When the results is a chronic cause, the Enlargement is firm or hard, with sharp edges. And enlarged spleen is usually nontender to palpation; tender only the peritoneum is also Also inflamed |
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Rebound tenderness: Assess rebound tenderness when the person reports abdominal pain but when you elicit tenderness during palpation. Choose a site away from the painful area. Hold your hand 90° or perpedicular to the abdomen. Push down slowly and deeply and lift up quickly. This makes structures that are indented by palpation rebound suddenly. The normal, or negative, response is no pain on release the pressure. Perform this test at the end of the examination, because it can cause severe pain and muscle rigidity.
-Pain on release of pressure confirms redound tenderness, which is a reliable sign of peritoneal inflammation. Peritoneal inflammation companies appendicitis |
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Melena:
the discharge of black, tarry, bloody stools, usually resulting from a hemorrhage in the alimentary tract. |
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| Epigastrium:the upper and median part of the abdomen, lying over the stomach. |
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Aneurysm:a permanent cardiac or arterial dilatation usually caused by weakening of the vessel wall.
Aortic aneurysm: Murmur is harsh, systolic, or continuous and accentuated with systole. Note in persons with hypertension |
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| Concave:curved like a segment of the interior of a circle or hollow sphere; hollow and curved. |
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| Convex:having a surface that is curved or rounded outward. |
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Contour:
the outline of a figure or body; the edge or line that defines or bounds a shape or object. |
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