Abdominal Palpation spleen and kidneys

Breathing instructions for spleen palpation?

Pt exhale and press in

Stay pressed in to feel spleen

Should you feel the spleen?

NO

Some causes for why the spleen might be palpable?

COPD

Emphysema

Chronic bronchitis

These cause the diaphragm to be low and flat

If you can palpate the spleen it is ___x it’s normal size

2.5-3 times normal size

Maximum size of aorta?

3 cm

Average aorta size?

1.7 cm

Best way to assess aorta?

Ultrasound

Risk factors for aortic aneurysm?

Elderly

Hypertensive pts

Smoking

Male

Rupture of aorta is ____ times more likely in AAA ____ than in smaller aneurysm, and carries a ___ to ___ mortality rate

15x

>4cm

85%-95% mortality rate

The USPSTF recommends ultrasound screening for ____ over ___ years old who have “ever smoked”

Men

65

Organs that may be tender in a healthy individual are the ____, ____, ____, ______

Aorta

Cecum

Sigmoid

Ovaries

Which kidney might be more palpable?

Right kidney bc it’s lower

How does exhaling affect the kidney?

It brings it up

Breathing instructions for capture method?

PT inhale first and you try to catch kidney

Breathing instructions for entrapment method

Pt exhale and try to trap kidney against rib cage so you can feel when they inhale

Enlarged kidney indicates

Hydronephritis

Tumor

Polycycstic kidney

Positive for Murphy’s punch means?

Potentially pyelonephritis

What is pyelonephritis?

Infection of kidney capsule

T/F the kidney, particularly the right one, may be palpable on thin individuals and children

True

T/F the kidney is normally not palpable?

True

What is a positive feeling for the entrapment method ?

The kidney pushes between the hands

What is a positive for the capture method

The kidney slips out from between the hands

Murphy’s ______ is performed over the _______ angle.

Punch

Costovertebral angle

Pain provoked by this test indicates ______

Pyelonephritis