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What is the proper position a patient should be in for an abdominal exam
Supine with arms at side and knees flexed
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In inspection part of the rectal examination, what do you have the patient do to visulaize fistulas?
Have patient bear down
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What is the proper procedure for the abdomenal assesment?
- Inspection
- Ausculatation
- Percussion
- Palpation
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What is a bluish periumbilical discoloration, found apon inpection of surface characteristics?
- Intraabdominal bleeding
- (Cullen Sign)
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Glistening taut apperance of the skin indicates what on the abdomen
Ascites
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Results from weight gain and pregnancy, origins pink or blue then turns silvery white over time. Also can be a sign of abdominal tumor
Striae
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Pearl-like enlarged umbillical node is a sign of what
Intraabdominal Lymphoma
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Describe the Alimentary tract
- Mouth to Pharaynx
- esophagus
- Stomach (pyloric orphis)
- Small intestines( duodenum, Jejunum, ileum-ileocecal valve)
- Large instestines( cecum, apendix, ascending, transverse, and decending)
- sigmoid colon
- Rectum
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Organs of the Right upper quadrant (RUQ)
- Liver and Gall Bladder
- Pylorus
- Duedenum
- Head of pancreas
- Right Adrenal Gland
- Portion of right kidney
- Hepatic flexure of colon
- Portions of the ascending and transverse colon
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Organs of the Right lower quadrant (RLQ)
- Lower pole of right kidney
- Cecum and Appendix
- Portion of ascending colon
- Bladder (if distended
- Ovary and salphinx
- Uterus
- Right spermatic cord
- Right ureter
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Organs of the left upper quadrant (LUQ)
- Left lobe of liver
- Spleen
- Body of Pancrease
- Stomach
- Transverse and desending colon
- Splenic flexure of colon
- left adrenal gland
- portion of left kidney
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Left Lower Quadrant (LLQ)
- Lower pole of left kidney
- Sigmoid colon
- Portion of desending colon
- Bladder if distended
- Ovary and salpinx
- Uretures if enlarged
- Left spermatic cord
- Left ureter
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Organs in the nine regions
1 Epaigastric
- Pyloric end of stomach
- Duodenum
- Pancrease
- Portion of liver
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Region 2 of abdomen
Umbilical
- Omentum
- Mesentery
- Lower part of duodenum
- Jejunum and ileum
-
3 rd region of the abdomen
Hypogastric
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What are the main organs of the GI tract
- The mouth
- Esophagus
- Stomach
- Small intestines
- Large intestines
- Anus
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Name the accessory organs of the GI tract
- Liver
- spleen
- pancrease
- gall bladder
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What are the affects on the GI tract that come with advance aging?
- Motility due to age related changes in the neurons
- collagen properties increase and decrease resistance of intestinal wall to stretching
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What does friction rubs in the abdomen represent
- Inflamation of the perotinial surface of the organ due to
- Tumor
- Infection
- Infarct
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Soft low pitch sound continous in the epigastric region and umbillicas
Venous hums
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Occurs with increased collateral circulation between portal and systemic venous systems
Venous hums
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The prolapse of one segment of the intestines into another causing an intestinal obstuction? Symptoms include acute intermittent abdominal pain, abdominal distension, vomiting, and passage of first normal brown stool, remaining stools will have blood and mucus
Intussusception
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What is the main risk factor for colorectal cancer?
Age
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What are some age risk screening for colorectal cancer
- Annual fecal occult blood test
- Flexible sigmoidoscopy every 5 years
- Annual FOBT plus flexible sigmoidoscopy every 5 years
- Double-contrast barium enema every 5 to 10 years
- Screening colonoscopy every 10 years
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Which hemorroids are usually painful
Internal hemmorrhoids that are thrommbosed, prolapsed, or infected.
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What are the concentric rings that keep the anal canal closed
Internal and external spincters
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The internal anal canal is lined by columns of mucosal tissue (columns of Morgagni) that fuse together to form
Anorectal junction
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What technique is used for dectcting a perineal absess
Bidigital exam
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Very light tan or gray stool indicates what?
Obstructive jaundice
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what is the color of the stool that indicates upper intestinal tract bleeding
Tarry black stool
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Risk factors for colorectal cancer family
- Family Hx of colon cancer,
- Family adenomatous polyposis
- family hereditary non polyposis colorectal cancer (HNPCC) Gardner syndrom
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Personal risk factors for cholorectal cancer
- HX ovarian cancer, endometrial or breast cancer
- Jewish decent
- Diet high in beef and animal fats, low in fiber
- obiesity
- smoking
- physical inactivity
- alcohol intake
- Hx colorectal cancer
- intestinal polyups, same as family
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Risk factors for prostrate cancer
- age 50 years
- Black race
- common in north america and eastern europe
- FMhx prostrate cancer
- diet high in animal fat
- high levels of androgen hormone
- physical inactivity
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Peritonitis pneumonic
- P-pain in front, back, sides, shoulders
- E-electrolytes fall
- R-rigidity or rebound tenderness
- I- Immobile abdomen or patient
- T-Tenderness
- O-Obstruction
- N- Nausea or vomiting
- I- Increase pulse, decreasing blood pressure
- T-temp falls
- I-Increasing girth of abdomen
- S-Silent abdomen
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This inflamation produces left lower quad pain, anorexia, nausea, vomiting, and altered bowel habits, usually constapitation
Signs are distended abdomen, with decreased bowel sounds and localixed tenderness
Dicerticulousis
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What maneuver is used to identify perotinal inflamation or positive appendicitis if the sign is seen in right lower quadrant
Rebound tenderness
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What test do you use to dectect for a ruptured appendicitis
Obturator
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What sounds should you expect to hear around the spleen
Tymphony to dullness
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