ADMOMEN

• Abdomen


  Bordered superiorly by the costal margins, inferiorly by the symphysis pubis and inguinal canals, and laterally by the flanks
• Abdominal quadrants


  • Right upper quadrant (RUQ)
  • Right lower quadrant (RLQ)
  • Left lower quadrant (LLQ)
  • Left upper quadrant (LUQ)
• Abdominal regions


  • Epigastric
  • Umbilical
  • Hypogastric or suprapubic
• Abdominal wall muscles


  • External abdominal oblique
  • Internal abdominal oblique
  • Transverse abdominis
  • Rectus abdominis
• Linea alba


  White line formed by the joining of muscle fibers and aponeuroses at the midline of the abdomen, extending vertically from the xiphoid process of the sternum to the symphysis pubis
• Functions of abdominal wall muscles

  • Protect the internal organs
  • Allow normal compression during functional activities such as coughing, sneezing, urination, defecation, and childbirth
• Peritoneum


  Thin, shiny, serous membrane lining the abdominal cavity (parietal peritoneum) and providing a protective covering for most of the internal abdominal organs (visceral peritoneum)
• Abdominal viscera


  • Gastrointestinal
  • Reproductive (female)
  • Lymphatic
  • Urinary
• Solid viscera


  Organs that maintain their shape consistently: liver, pancreas, spleen, adrenal glands, kidneys, ovaries, uterus
• Hollow viscera


  Structures that change shape depending on their contents: stomach, gallbladder, small intestine, colon, bladder
• Whether abdominal viscera are palpable depends on location, structural consistency, and size
• Liver


  • Largest solid organ in the body
  • Located below the diaphragm in the RUQ
  • Composed of four lobes
• Functions of the liver


  • Accessory digestive organ
  • Variety of metabolic and regulatory functions including glucose storage, formation of blood plasma proteins and clotting factors, urea synthesis, cholesterol production, bile formation, destruction of red blood cells, storage of iron and vitamins, and detoxification
• In many people, the liver extends just below the right costal margin, where it may be palpated
• Kidneys


  • Glandular, bean-shaped organs
  • Located high and deep under the diaphragm, approximating the level of the T12 to L3 vertebrae
  • Tops protected by the posterior rib cage
• Functions of the kidneys


  • Filtration and elimination of metabolic waste products
  • Role in blood pressure control and maintenance of water, salt, and electrolyte balances
  • Endocrine function by secreting hormones
• In some thin clients, the bottom portion of the right kidney may be palpated anteriorly
• Stomach


  • Distensible, flask-like organ
  • Located in the LUQ just below the diaphragm and between the liver and spleen
  • Not usually palpable
• Functions of the stomach


  Store, churn, and digest food
• Gallbladder


  • Muscular sac approximately 10 cm long
  • Located near the posterior surface of the liver lateral to the mid-clavicular line
  • Not normally palpated
• Functions of the gallbladder


  Concentrate and store the bile needed to digest fat
• Pancreas


  • Located mostly behind the stomach deep in the upper abdomen
  • Normally not palpable
  • Extends across the abdomen from the RUQ to the LUQ
• Functions of the pancreas

  • Endocrine gland
  • Accessory organ of digestion
• Spleen


  • Approximately 7 cm wide
  • Located above the left kidney just below the diaphragm at the level of the ninth, tenth, and eleventh ribs
  • Posterior to the left mid-axillary line and posterior and lateral to the stomach
  • Normally not palpable
• Functions of the spleen

  • Filter the blood of cellular debris
  • Digest microorganisms
  • Return the breakdown products to the liver
• When the spleen enlarges, the lower tip extends down and toward the midline
• Small intestine


  • Longest portion of the digestive tract (approximately 7.0 m long)
  • Small diameter (approximately 2.5 cm)
  • Not normally palpated
• Functions of the small intestine

  Digestion and absorption of nutrients through millions of mucosal projections lining its walls
• Colon (large intestine)


  • Wider diameter than the small intestine (approximately 6.0 cm)
  • Approximately 1.4 m long
  • Composed of three major sections: ascending, transverse, and descending
  • Sigmoid colon often felt as a firm structure on palpation, while cecum and ascending colon may feel softer
  • Transverse and descending colon may also be felt on palpation
• Functions of the colon

  • Secrete large amounts of alkaline mucus to lubricate the intestine and neutralize acids formed by the intestinal bacteria
  • Absorb water, leaving waste products to be eliminated in stool
• Urinary bladder


  • Distensible muscular sac located behind the pubic bone in the midline of the abdomen
  • Functions as a temporary receptacle for urine
  • A bladder filled with urine may be palpated in the abdomen above the symphysis pubis
• Abdominal aorta and major branches

  • Aorta branches into the right and left iliac arteries just below the umbilicus
  • Pulsations of the aorta frequently visible and palpable midline in the upper abdomen
  • Pulsations of the right and left iliac arteries may be felt in the RLQ and LLQ
• Indigestion (pyrosis)


  Often described as heartburn, may be an indication of acute or chronic gastric disorders including hyperacidity, gastroesophageal reflux disease (GERD), peptic ulcer disease, and stomach cancer
• Heartburn


  Acid indigestion, a burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen
• Many clients call indigestion gassiness, belching, bloating, and nausea
• Certain factors (e.g., food, drinks, alcohol, medications, stress)

  Increase gastric secretion and acidity and cause or aggravate indigestion
• Indigestion accompanied by nausea, vomiting, diarrhea or constipation indicates more than local irritation and needs further investigation
• Nausea


  May reflect gastric dysfunction and is also associated with many digestive disorders and diseases of the accessory organs, such as the liver and pancreas, as well as with renal failure and drug intolerance
• Nausea may occur at particular times such as early in the day with some pregnant clients ("morning sickness"), after meals with gastric disorders, or between meals with changes in blood glucose levels
• Nausea and vomiting associated with strenuous exercise are thought to relate to dehydration, hyponatremia, heat intolerance, a vagal reaction, or gastroesophageal reflux