-Anatomy: where organs are located in the abdominal cavity:

RIGHT UPPER QUAD

LEFT UPPER QUAD
Liver and Gallbladder
Left Lobe of Liver
Pylorus
Spleen
Duodenum
Stomach
Head of Pancreas
Body of Pancreas
Right Adrenal Gland
Left Adrenal Gland
Portion of Right Kidney
Portion of left kidney
Portions of Ascending and
Portions of transverse and
Transverse Colon
Descending Colon
RIGHT LOWER QUAD
LEFT LOWER QUAD
Lower Pole of Right Kidney
Lower Pole of Left Kidney
Cecum and Appendix
Sigmoid Colon
Portion of Ascending Colon
Portion of Descending Colon
Bladder (If distended)
Bladder (If distended)
Right Ureter
Left Ureter
Right Ovary and Salpinx
Left Ovary and Salpinx
Uterus (If enlarged)
Uterus (If enlarged)
Right Spermatic Cord
Left Spermatic Cord
Which organs can you palpate/feel/find?
-What does the alimentary tract consist of and do?

-routine assessment techniques and expected findings.

-When/how do you inspect, auscultate, palpate, and percuss the abdomen
-the position of your patient?
-What does the abdomen look like?
-Which sounds do you expect to hear in the abdomen?
-What would you hear if fluid was present (full bladder or fluid wave)? Shifting dullness & fluid
wave = ascites; full bladder = dullness
-Where/how do you assess bowel sounds? Auscultate bowel sounds from URQ then in
clockwise direction.
-What are these expected findings? Bowel sounds normoactive with sounds every 5-15 seconds,
broad range of sounds high pitched, low, rumbling, etc.
Read Special Circumstances (begins on page 276) concentrating on:
-CVAT (Fig. 13-18) direct and indirect percussion of kidneys to test for inflammation.
Positivity is tenderness with percussion; indicated kidney disease.
-Rebound tenderness indicates inflammation of the peritoneum; press firmly at 90* in area
away from pain; release quickly if there is more pain in release than press, then indicates
inflammation.
-McBurneys Sign pain in area between right iliac crest and umbilicus indicates appendicitis
-Iliopsoas Muscle Test tell pt to lay supine, and lift right leg, flexing at hip, push down on leg
hile they try to resist; pain in RLQ signals acute appendicitis.
-Obturator Muscle Test signifies ruptured appendix; supine, flex right hip and knee 90*, hold
leg above knee, rotate; pain is positive sign
-Floating mass perform ballottement push at 90* - mass moves upward; fetal head or
abnormal growth
Risks factors for cancers (page 287-288)
-stomach higher in Asians, then Hispanic, AA, blood type A, stomach surgery, SMOKERS
DOUBLE THE RISK, salted and smoked foods, H. pylori infections
-liver higher in Asians, males, Hepatitis B+C increased risk, obesity bc of fatty liver, cirrhosis
-esophageal 70-80 yo, Barretts esophagus via GERD, overweight, lack of fruits and veggies
-colon 90% of pt over the age of 50. Alcohol use increases risk, 3-4 DECADES OF
SMOKING INCREASES RISK FOR CANCER, MORE FOR RECTAL CANCER, sedentary
lifestyle, DIABETES, red meat, 1st generation relative history
-pancreatic - ~72 yo, males, AA b/c of smoking and diabetes, 5-10% inheritance tendency, red
meats and fats, SMOKING IS A 2-3X INCREASED RISK