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Abdomen - Coggle Diagram

- - - - skin characteristcs
        
        lesions esp painful umbilical nodule may = cancer
        
        Ask about scars, may = intraabdominal adhesions
      - venous return patterns
      - symmetry
      - surface motion
        
        peristalsis seen in thin individuals
        
        aortic pulsations may = aortic aneurysm
      - Contour: abdominal profile from ribs to pubis
        
        Distention
        
        General symmetric
        
        obesity
        
        enlarged organs
        
        fluid/gas
        
        Lower: From umbilicus to symphysis
        
        ovarian tumor
        
        pregnancy
        
        fibroids
        
        full bladder
        
        Upper: above umbilicus
        
        tumor
        
        pancreatic cyst
        
        gastric dilation
    - - Masses
      - Hernia
      - Separation
  - - - gastritis
      - early obstruction
      - hunger
    - - perionitis
      - paralytic ileus
    - - Friction rubs over liver/spleen (high pitched with inspiration)
      - Bruit: auscultate with the bell
  - - - Tympany
        
        higher pitched than resonance
        
        over air-filled viscera
      - Hyperresonance
        
        pitch between tympany and resonance
        
        base of left lung
      - Resonance
        
        sustained note of moderate pitch
        
        over lung tissue
      - dullness
        
        short, high-pitched note with little resonance
        
        over solid organs adjacent to air-filled structures
    - - Should be tympanic but may be dull
        after full meal or feces-filled intestines
  - - - muscular resistance
      - tenderness
      - masses
    - - Bulges/masses around umbilicus
      - liver border in right costal margin
      - Gallbladder below liver margin
      - Spleen in left costal margin
      - Right and Left kidneys
      - Aortic pulsation in midline
- - - - Subjective: chronic diarrhea; systemic manifestations such as arthritis, iritis; characterized by flares and remissions
      - Objective: may have RLQ tenderness, perianal skin tags, fistulae, abscesses; cobblestone appearance of mucosa
    - - Subjective: bloody, frequent diarrhea
        (20-30/day); weight loss, fatigue
      - Objective: do not have fistulae or perianal dx; may cause sclerosing cholangitis; mucosal edema with ulcerations
    - - Subjective: LLQ pain, n/v, constipation
      - Objective: may have abd distention, decreased bowel sounds, lower GI bleed may occur
  - - - Subjective: jaundice, anorexia, clay-colored stools, tea-colored urine, fatigue
      - Objective: abnormal LFT, jaundice,
        hepatomegaly, may develop cirrhosis
    - - Subjective: jaundice, anorexia, clay-colored stools, tea-colored urine, fatigue; prominent abd vasculature, cutaneous spider angiomas
      - Objective: hepatomegaly, hepatic encephalopathy, acities, muscle wasting, coagulopathies
    - - Subjective: most are asymptomatic, some RUQ pain, fatigue, jaundice, malaise
      - Objective: abnormal LFT, hepatomegaly, ascities
  - - - Subjective: nonspecific, nausea/malaise, flank pain
      - Objective: may include edema, htn,
        oliguria, micro hematuria children: periorbital edema,
    - - Subjective: symptoms of pyelonephritis persist after 72 hours of ABX
      - Objective: ill-appearing, CVA tenderness, pyruria and bacturia
- - - - Subjective: acute intermittent abd pain, distention, voming, dramatic in onset, consolable crying, currant jelly stool
      - Objective: sausage-shaped mass in either RUQ or LUQ, air-contrast enema
    - - Subjective: regurgitation --> projectile
        vomiting, failure to gain weight
      - Epigastric distention, small olive-shaped
        mass sometimes palpable in RUQ,
    - - Subjective: newborns with failure to pass meconium in first 24hrs, vomiting, distention
      - Objective: in complicated cases= s/sx of shock,
    - - Subjective: jaundice, clay-colored stools, dark urine, failure to gain weight
      - Objective: firm liver, spelnomegaly, may have heart murmur
    - - Subjective: most asymptomatic (incidental finding), bloody stool without pain, others very painful similar to acute appendicitis, bilious emesis
      - Objective: painless rectal bleeding, symptoms of obstruction
    - - Subjective: range from subtle to severe (feeding intolerance, abd distention, vomiting, bloody stools)
      - Objective: lethargy, abd distention, apnea, pneumatosis intestinalis (gas cysts in bowel); often fatal d/t perforation and sepsis
  - - - Subjective: asymptomatic abdominal mass, may include loss of appetitie, weight loss, protrusion of one or both eyes
      - firm, fixed, nontender, irregular, and
        nodular abdominal mass that crosses midline
    - - Subjective: painless enlargement of abdomen or mass, some abd pain, vomiting, hematuria
      - firm, nontender mass deep within the flank
    - - Subjective: symptoms begin at birth, failure to thrive, constipation, v/d
      - Objective: severe constipation
    - - Subjective: preceding URI or gastroenteritis, fever, abd pain, v/d
      - Objective: dehydration, edema, petechiae, hepatosplenomegaly
- - - - Pulsations in epigastrum common
      - superficial veins
        
        usually visible in thin infants
        
        distended veins
        
        vascular obstruction
        
        abdominal distention
        
        obstruction
      - Spider nevi may indicate liver disease
      - Umbilical hernia
        
        measure diameter of opening rather than contents
        
        maximum size generally reached by 1 month
        
        Usually close spontaneously by 1 to 2 YO