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Abdomen - Coggle Diagram
Abdomen
Physical exam
Inspection
General
skin characteristcs
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Ask about scars, may = intraabdominal adhesions
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Landmarks
Nine regions : 1. epigastric, 2. umbilical, 3. hypogastric 4 5. (upper sides) right and left hypochondriac, 6 7 (middle sides) right and left lumbar, 8 9 (bottom sides) right and left inguinal
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Percussion
Notes
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dullness
short, high-pitched note with little resonance
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Kidneys: when sitting, percuss CVA wih fist
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Pain Assessment
Qualities
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Cramping: biliary colic, gastroenteritis
colicky: appendicitis, renal stone
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Sudden: Duodenal ulcer, acute pancreatits, obstruction, perforation
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Obturator muscle test
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Supine, flex right leg to 90/90, rotate leg laterally and medially
Abnormalities
Alimentary tract
Crohn Disease: can affect any part of the GI tract produces ulceration, fibrosis, and malabsorption
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
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Diverticular disease
Subjective: LLQ pain, n/v, constipation
Objective: may have abd distention, decreased bowel sounds, lower GI bleed may occur
Hipatobiliary System
Hepatitis
Subjective: jaundice, anorexia, clay-colored stools, tea-colored urine, fatigue
Objective: abnormal LFT, jaundice,
hepatomegaly, may develop cirrhosis
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
Nonalcoholic fatty liver disease (NAFLD): ranging from steatosis to cirrhosis and hepatocellular carcinoma
Subjective: most are asymptomatic, some RUQ pain, fatigue, jaundice, malaise
Objective: abnormal LFT, hepatomegaly, ascities
Kidney
Acute glomerulonephritis
Subjective: nonspecific, nausea/malaise, flank pain
Objective: may include edema, htn,
oliguria, micro hematuria children: periorbital edema,
Renal Abscess: infection of medulla of cortex of kidney (in cortex= gram +; in the medulla = gram -)
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Objective: ill-appearing, CVA tenderness, pyruria and bacturia
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