abdomen

• right upper quadrant:

  • liver
  • gallbladder
  • duodenum
  • right kidney and adrenal
  • hepatic flexure
  • ascending and transverse
• left upper quadrant:

  • stomach
  • spleen
  • pancreas
  • left kidney and adrenal
  • splenic flexure
  • descending and transverse
• right lower quadrant

  • cecum
  • appendix
  • right ovary and tube
  • ureter
• left lower quadrant:

  • descending colon
  • sigmoid colon
  • ovary and tube
  • ureter
• abdominal region:

  TOP: hypochondriac, epigastric

  MIDDLE: lumbar, umbilical

  BOTTOM: iliac, hypogastric
• sequence of assessment for abdomen is inspection > auscultation > percussion > palpation
• bowel sound is reffered to as borborygmi
• vascular sounds

  A) femoral artery

  B) iliac artery

  C) umbilicus

  D) abdominal aorta

  E) renal artery

  F) abdominal aorta
• height of liver

  lower border of liver: costal margin (1-4 cm)

  upper border of liver: right 5th to 7th ICL

  midclavicular line: 6-12 cm

  midsternal line: 4-8 cm
• auscultating bowel sound

  RLQ > RUQ > LUQ > LLQ
• percussing abdomen

  LLQ > RLQ > RUQ > LUQ
• most common cancer is colon cancer that we get from eating raw and smoked food
• normal consistency of stool are soft and formed, color brown, and has an aromatic odor
• most common food intolerance is lactose intolerance
• belching means always burping
• hematemesis means vomitting blood
• if client has a bleeding ulcer and digest his own blood, it will mix with the stool and will cause melena
• melena is a black tarry stool caused by upper GI bleeding
• dyspepsia means indigestion (overeating)
• flatulence is excess gas

  • gas forming foods: cabbage, root crops (kamote)
• difficulty in swallowing could indicate esophageal cancer
• diarrhea - lose watery stool
• constipation - dry, hard stool
• bowel incontinence - lack of control
• clay colored stool - biliary problem
• hemorrhoids - pain or bleeding
• itching - pinworm
• acites - swelling in abdomen
• position when assessing the abdomen: dorsal recumbent or supine with pillow under the knees (to relax the muscles)
• palpation is last to not falsely increase the bowel sounds
• blue or red stirae may indicate cullen's sign

  • can also be seen in the sides - intraabdominal bleeding
• everted umbilicus may indicate hernia
• to assess the contour of abdomen: stand at the side of the head/feet and look 45 degrees (flat, round, scaphoid, protuberant)
• aortic pulsation is seen 2 fingers above the umbilicus
• normal borborygmi per minute is 5 to 30 (normoactive)

  • hypoactive: constipation
  • hyperactive: diarrhea
• thorax - resonance

  abdomen - tympany

  organ - dullness

  bone and muscle - flat
• spleen and liver is dull
• hyperresonance could mean that there are too much gas in the intestine
• blunt percussion is done over the kidney, you will percuss on the costovertebral angle (lumbar)
• peritoneal cavity dont contain the kidney