Health & Physical Assessment in Nursing First Edition

1. Health & Physical Assessment in NursingFirst Edition Donita D’AmicoandColleen Barbarito Chapter 19 Abdomen

2. LEARNING OBJECTIVE ONE

3. LEARNING OBJECTIVE ONE • Abdomen • Gastrointestinal system • Structures of other body systems

4. LEARNING OBJECTIVE ONE • Gastrointestinal System

5. Figure 19.1 Organs of the alimentary canal and related accessory organs.

6. LEARNING OBJECTIVE ONE • Gastrointestinal System • Alimentary canal • Mouth • Pharynx • Esophagus • Stomach • Small and large intestines • Rectum • Anus

7. LEARNING OBJECTIVE ONE • Gastrointestinal System • Accessory organs • Teeth • Salivary glands • Liver • Gallbladder • Pancreas

8. LEARNING OBJECTIVE ONE • Related Structures • Peritoneum • Abdominal wall muscles

9. Figure 19.2 Muscles of the abdominal wall.

10. LEARNING OBJECTIVE ONE • Related Structures • Aorta

11. Figure 19.3 Abdominal vasculature and deep structures.

12. LEARNING OBJECTIVE ONE • Related Structures • Kidneys • Ureters • Bladder • Spleen • Reproductive organs

13. LEARNING OBJECTIVE TWO

14. LEARNING OBJECTIVE TWO • Abdomen • Largest cavity of the body • Contains structures from the digestive system and other body systems

15. LEARNING OBJECTIVE TWO • Abdomen - Inferior to the Diaphragm and Superior to the Pelvic Floor

16. LEARNING OBJECTIVE TWO • Abdominal Landmarks • Xiphoid process • Umbilicus • Costal margin • Iliac crests • Pubic bone

17. LEARNING OBJECTIVE TWO • Mapping - Dividing the Abdomen into Four Quadrants and Nine Regions

18. LEARNING OBJECTIVE TWO • Four Quadrants

19. Figure 19.4 Mapping of the abdomen into four quadrants.

20. LEARNING OBJECTIVE TWO • Four Quadrants • Midsternal line from the xiphoid process through the umbilicus to the pubic bone • Horizontal line perpendicular to the first line, through the umbilicus • Two perpendicular lines form four equal quadrants of the abdomen

21. LEARNING OBJECTIVE TWO • Four Quadrants • Quadrants named • Right upper quadrant (RUQ) • Right lower quadrant (RLQ) • Left upper quadrant (LUQ) • Left lower quadrant (LLQ)

22. LEARNING OBJECTIVE TWO • Four - Quadrant Method • Gallbladder • Kidneys • Costovertebral angle • Liver • Spleen • Midline structures • Abdominal aorta • Urinary bladder • Uterus

23. LEARNING OBJECTIVE TWO • Nine Regions

24. Figure 19.5 Mapping of the abdomen into nine regions.

25. Figure 19.6 Upper torso: Organs of the four abdominal quadrants. Lower torso: Organs of the nine abdominal regions.

26. LEARNING OBJECTIVE TWO • Nine Regions • Extend the right and left midclavicular lines to the groin • Horizontal line across the lowest edge of the costal margin • Horizontal line at the level of the iliac crests • Abdomen divided into nine regions

27. LEARNING OBJECTIVE TWO • Nine Regions • Names of the regions • Right hypochondriac • Epigastric • Left hypochondriac • Right lumbar • Umbilical • Left lumbar • Right inguinal • Hypogastric or pubic • Left inguinal

28. LEARNING OBJECTIVE THREE

29. LEARNING OBJECTIVE THREE • Focused Interview • General questions

30. LEARNING OBJECTIVE THREE • Specific Questions • Illness or infection • Symptoms • Pain • Behaviors • Infants and children • Pregnant female • Older adult • Environment

31. LEARNING OBJECTIVE FOUR

32. LEARNING OBJECTIVE FOUR • Equipment • Examination gown and drape • Examination gloves • Examination light • Stethoscope • Skin marker • Metric ruler • Tissues • Tape measure

33. LEARNING OBJECTIVE FOUR • Other Considerations • Age • Gender • Language • Culture

34. LEARNING OBJECTIVE FIVE

35. LEARNING OBJECTIVE FIVE • Abnormal Abdominal Findings • Abnormal sounds

36. Table 19.1 Abnormal Abdominal Sounds

37. LEARNING OBJECTIVE FIVE • Abnormal Abdominal Findings • Pain

38. Table 19.2 Pain in Common Abdominal Disorders

39. Figure 19.25Referred cutaneous pain areas. A. Anterior. B. Posterior. A

40. Figure 19.25 (continued)Referred cutaneous pain areas. A. Anterior. B. Posterior. B

41. LEARNING OBJECTIVE FIVE • Abnormal Abdominal Findings • Distention • Hernias

42. LEARNING OBJECTIVE FIVE • Abnormal Abdominal Sounds • Hypo- and hyperactive bowel sounds • Vascular sounds of bruits and venous hums • Friction rubs

43. LEARNING OBJECTIVE FIVE • Abdominal Pain • Direct • Referred

44. LEARNING OBJECTIVE FIVE • Abdominal Distention • Obesity

45. Figure 19.26Obesity.

46. LEARNING OBJECTIVE FIVE • Abdominal Distention • Gas

47. Figure 19.27Distended abdomen.

48. LEARNING OBJECTIVE FIVE • Abdominal Distention • Tumor

49. Figure 19.28Abdominal tumor.

50. LEARNING OBJECTIVE FIVE • Abdominal Distention • Ascites