Deck 18: Abdomen

Question 1

Identify the organs located within each of the four abdominal quadrants.

Answer 1

The right upper quadrant contains the liver and gallbladder, the duodenum, the head of the pancreas, the right adrenal gland, a portion of the right kidney, the hepatic flexure of the colon, and portions of the ascending and transverse colon. The left upper quadrant contains the left lobe of the liver, the spleen, and the stomach, the body of the pancreas, the left adrenal gland, a portion of the left kidney, the splenic flexure of the colon, and portions of the transverse and descending colon. The right lower quadrant contains the lower pole of the right kidney, the cecum and appendix, a portion of the ascending colon, the right ureter, and the right ovary and fallopian tube, or right spermatic cord. The left lower quadrant contains the lower pole of the left kidney, the sigmoid colon, a portion of the descending colon, the left ureter, and the left ovary and fallopian tube or left spermatic cord. In addition, several structures lie in the midline including the abdominal aorta, the urinary bladder (if distended), and the uterus (if enlarged).

Question 2

Identify pertinent topics that must be reviewed during the abdominal portion of the interview.

Answer 2

Subjective data obtained from the patient serve as a guide for the examiner in identifying actual or potential problems related to the gastrointestinal system. As the examiner gains experience, the depth of questioning will be based on the prior responses of the patient. Topics that are of special relevance to the abdomen include nutrition and appetite, ability to chew and swallow foods, food intolerances or nausea and vomiting, and any pain associated with the abdomen. Questions to identify bowel habits and use of any laxatives must be included. The interview must also obtain information regarding any present or past rectal problems and gastrointestinal problems. Because many medications are metabolized by the liver or have gastrointestinal side effects, a review of current medications is also indicated.

Question 3

Use measures that will enhance abdominal wall relaxation.

Answer 3

If the abdomen is to be assessed accurately, patient relaxation is essential. The bladder must be empty, the room a comfortable temperature, the patient comfortable with knees supported and arms at the sides, and good lighting and visualization of the entire abdomen available. Make sure the stethoscope end piece is warm and that your fingernails are short. Examine painful areas last to avoid muscle guarding.

Question 4

Use the correct sequence of examining techniques.

Question 5

Interpret findings obtained during inspection of the abdomen.

Question 6

Interpret findings obtained during auscultation of the abdomen.

Question 7

Interpret findings obtained during percussion of the abdomen.

Question 8

Interpret findings obtained during palpation of the abdomen.

Question 9

Incorporate health promotion concepts when performing an assessment of the abdomen.