Health Assessment Ch 21: Abdomen

Key Terms
Anorexia nervosa An eating disorder that causes people to obsess about their weight
and the food they eat. People with anorexia nervosa attempt to
maintain a weight that's far below normal for their age and height. To
prevent weight gain or to continue losing weight, people with
anorexia nervosa may starve themselves or exercise excessively. Its
not about food, it’s about coping with emotional problems: thinness =
self worth. They engage in binging and purging. They also may
misuse laxatives, diuretics, or enemas. Screen any extremely thin
teenage girl for this.
Symptoms: extreme weight loss, thin appearance, abnormal blood
counts, fatigue, insomnia, dizziness or fainting, blush discoloration of
the fingers, brittle nails, hair that thins breaks or falls out, absence of
menstruation, constipation, dry skin, intolerance of cold, irregular
heart rhythms, low BP, dehydration, osteoporosis, swelling of the
arms or legs.
ascites Definition: free fluid in the peritoneal cavity. Occurs with heart
failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and
cancer.
Inspection: single curve. Everted umbilicus. Bulging flanks when
supine. Taut, glistening skin, recent wt. gain. Increase in abdominal
girth.
Auscultation: normal bowel sounds over intestines. Diminished over
ascitic fluid.
Percussion: tympany at top where intestines float. Dull over fluid.
Produces fluid wave and shifting dullness.
Palpation: taut skin and increased intraabdominal pressure limit
palpation.
borborygmus A type of hyperactive bowel sound. Hyperperistalsis when you feel
your “stomach growling.” Loud, high pitched, rushing, tinkling
sound that signals increased motility.
bruit Turbulent blood flow within a blood vessel. Using firm pressure
check the aorta, renal arteries, iliac, and femoral arteries, especially in
people with hypertension. Usually this sound is not heard.
costovertebral angle The angle formed by the twelfth rib and vertebral column. Location
of the kidneys.
dysphagia Difficulty swallowing. Occurs with disorders of the throat and
esophagus.
epigastric region A regional description for the area between the costal margins.
fluid wave Tests for large amounts of ascitic fluid. Stand on the person’s right
side and place ulnar edge of another examiner’s hand on the patient’s
abdomen in the midline. Place your left hand on th person’s right
flank. With your right hand, reach across the abdomen and give the
left flank a firm strike. If ascites if present, the blow will generate a
fluid wave through the abdomen and you will feel a distinct tap on
your left hand. If the abdomen is distended from gas or adipose tissue
you will feel no change.
hematemesis Vomiting of blood.
Health Assessment Ch 21: Abdomen
hernia Part of an internal organ bulges though a weak area of muscle.
hypogastric/suprapubi Regional description of area above the pubic bone but below the
c region umbilical region.
iliopsoas muscle test When the iliopsoas muscle is inflamed, pain is felt in the right lower
quadrant. Perform this test with the acute abdominal pain of
appendicitis is suspected. With the person supine, lift the right leg
straight up, flexing at the hip; then push down over the lower part of
the right thigh as the person tries to hold the leg up.
inspiratory arrest Hold fingers under the liver border. Ask the person to take a deep
(Murphy's sign) breath. If the gallbladder is inflamed, the descending liver pushes it in
the examining hand, causing a sharp pain and the person will
abruptly stop inspiration midway.
melena Black tarry feces associated with gastrointestinal bleeding.
obturator test Performed when appendicitis is suspected. With the person supine,
lift the right leg, flexing at the hip and 90 degrees at the knee. Hold
the ankle and rotate the leg internally and externally. A negative
normal response is no pain. A perforated appendic irritates the
obturator muscle.
pica Appetite for non food items.
purging Associated with eating disorders where a person intestinally vomits
to reduce the calories absorbed by the body.
pyrosis Heartburn. Burning sensation in esophagus and stomach from reflux
of gastric acid.
rebound tenderness A sign of peritoneal inflammation, usually accompanying
(Blumberg's sign) appendicitis. Assess rebound tenderness when the person reports
abdominal pain or when you elicit tenderness during palpation.
Chose a site away from the painful area. Hold your hand 90 degrees,
or perpendicular to the abdomen. Push down slowly and deeply; then
lift up quickly. A normal response is no pain on release of pressure.
referred pain The location of the pain may not necessarily be over the involved
organ. Pain may be referred to a site where the organ was located in
fetal development. Pg. 590 Jarvis.
shifting dullness A test for large amount of ascites. It will not detect less than 500 ml
of fluid.
succession splash The sound elicited by shaking the body of a person who has free fluid
and air or gas in a hollow organ or body cavity. This sound may be
present over a normal stomach. Can be heard with pyloric obstruction
or large hiatus hernia.
tympany A hollow drum-like sound produced when a gas-containing cavity is
tapped sharply. Tympany is heard if the abdomen is distended with
gas.
umbilical region Regional description of the area around the umbilicus.
viscera Inside the abdominal cavity, all the internal organs are called viscera.
Solid viscera have a characteristic shape (liver, spleen, pancreas,
adrenal glands, kidneys, ovaries, and uterus). Hollow viscera shape
depends on its contents: (stomach, gallbladder, small intestine, colon,
and bladder).