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Where is the epigastric region in respect to the umbilicus?
Above the umbilical region.
Where is the hypogastric region in respect to the umbilicus?
Below the umbilical region.
What is located in the right upper quadrant (RUQ)?
Ascending and transverse colon, duodenum, gallbladder, hepatic flexure of color, liver, head of pancreas, pylorus, right adrenal gland, right kidney (upper pole), and right ureter.
What is located in the right lower quadrant (RLQ)?
Appendix, ascending colon, cecum, right kidney (lower pole), right ovary and tube, right ureter, right spermatic cord.
What is located in the left upper quadrant (LUQ)?
Left adrenal gland, left kidney (upper pole), body and tail of pancreas, spleen, splenic flexure of colon, stomach, transverse descending colon
What is located in the left lower quadrant (LLQ)?
Left kidney (lower pole), left ovary and tube, left ureter, left spermatic cord, descending and sigmoid colon.
What is located at the midline?
Bladder, uterus, prostate gland.
What is peptic ulcer disease (PUD)?
Ulcers in esophageal lining, stomach, SI and erode underlying lining of organs.
What are modifiable risk factors for PUD?
use of NSAIDs and smoking
What are NON-modifiable risk factors for PUD?
Presence of H.pylori, stress, hypersecretory conditions, fam HX, radiation treatment, Zollinger-ellison syndrome (tumor in pancreas → too much acid-producing hormone)
What education can you provide for PUD?
Washing hands, eat COOKED food, low dosages of NSAIDs, reduce alcohol consumption, smoking cessation.
What is GERD?
Gastroesophageal reflux disease → Stomach acid flow back into esophagus and can lead to narrowing or cancer.
What are RF for GERD?
Obesity, hiatal hernia, pregnancy, smoking, dry mouth, asthma, diabetes, CT disorders, alcohol consumption, and delayed stomach emptying.
What education can you provide for GERD?
Avoid alcohol and smoking, avoid certain foods, like spicy, 5-6 small means, eat slow, remain upright after eating for 2 hrs, avoid snacks, and avoid too much activity.
What is visceral pain?
Hollow organs become distended or contract forcefully. Characterized by dull, aching, burning, cramping pain. It is poorly defined or intermittently timed.
What is parietal pain?
Parietal peritoneum becomes inflamed. Localized, steady, severe pain. (EX: appendicitis)
What is referred pain?
Pain at different site that are innervated at same level. Highly localized.
What is indigestion an indicator of?
Whether it is an acute or chronic disorder.
What is grey-turner sign?
Bleeding within abdominal wall
What is jaundice?
Yellowing of the skin, maybe more apparent on abdomen. Issue with liver.
What is borborygmi?
Accentuated hyperactive bowel sounds.
When is tympany/hyperresonance heard?
Air in stomach and intestines
When is dullness heard?
solid matter. enlarged organs like liver or spleen.
When is abnormal dullness heard?
Distended bladder, large masses, or ascites
Do you palpate pulsations or tender organs?
NO
What are findings found in older clients?
Sensitivity to pain decreased, appetite decline, risk for complications r/t diarrhea, UTI, dilated superficial capillaries, liver size decreases after 50 yo, check width of aorta if 50+/HTN pt.
What does an abdominal X-RAY assess?
Causes of pain , organ and structures
What to educate the patient in regards to abd. x-ray?
It is painless, no need to fast, can NOT wear metal
What is a colonoscopy?
Examine rectum and lower bowel. Start around the age of 50.
What to educate pt in regards to colonoscopy?
Requires prep by fasting and emptying bowels.
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