Abdomen Physical Exam (Bates). Exam Questions and answers, rated A+

Abdomen Physical Exam (Bates). Exam Questions and answers, rated A+ When divided into 9 sections, what are the midline 3 sections called? (from top to bottom) - -Epigastric, Umbilical, Hypogastric (or suprapubic) What structures are not usually palpable? - -Most of liver, gallbladder, stomach, pancreas, appendix What structure is commonly misidentified as a tumor in the epigastrium? - -xiphoid process Where is the abdominal aorta usually palpable? - -Epigastrium What quadrant is the spleen located in? - -Left upper quadrant Describe location of spleen - -Lateral to and behind the stomach, just above left kidney (in midaxillary line) What ribs protect most of the spleen? - -9th, 10th, 11th ribs What is palpable in lower left quadrant? - -Descending and sigmoid colon What structure is commonly mistake for a tumor in the hypogastrium? - -S1 vertebra Where is a distended bladder palpable? - -Above pubis symphysis How much volume does the bladder usually hold? - -~300mL What structures support the bladder and proximal urethra in a female? - -Pelvic muscles and ligaments (required to maintain proper anatomic relations) What mechanism controls infantile bladder voiding? - -reflex mechanisms in sacral spinal cord How do you assess the integrity of sacral nerves that innervate the bladder? - -Perirectal and perineal sensation in S2, S3, S4 dermatomes. What forms the costovertebral angle? - -lower border of 12th rib and transverse process of upper lumbar vertebrae Where do you examine for kidney tenderness? - -Costovertebral angle How should the patient be draped for abdominal exam? - -exposure of the abdomen from just above xiphoid process to the pubis symphysis Where should the patients arms be placed during an abdominal exam? - -arms folded across chest or at sides Why can't a patient have their arms above their head during an abdominal exam? - -Causes stretching and tightening of abdominal wall, making palpation difficult How can we reduce exam complications due to an excessively ticklish patient? - -Start palpations with patient's hand under yours... then slip your hand underneath to palpate directly What is the order of the 4 major components of abdominal exam? - -Inspection, auscultation, percussion, and palpation When we start inspection of a patient, where should we position ourselves? - -On the patient's right