Health Assessment Exam 4
Health Assessment Exam #4 Chapter 21: Abdomen (approx. 21 questions)
1. Aortic pulsation
a. Normally, you may see the pulsations from the aorta beneath the skin in the epigastric area, particularly in thin persons with good muscle wall relaxation.
b. Marked pulsation of aorta occurs with widened pulse pressure (e.g., hypertension, aortic insufficiency, thyrotoxicosis) and with aortic aneurysm.
c. lateral pulsation with aortic aneurysm pushes the examiner's two fingers apart.
2. Light vs. deep palpation
a. Light palpation
a.i. With the first four fingers close together, depress the skin about 1 cm. Make a gentle rotary motion, sliding the fingers and skin together. Then lift the fingers (do not drag them) and move clockwise to the next location around the abdomen. The objective here is not to search for organs but to form an overall impression of the skin surface and superficial musculature. Save the examination of any identified tender areas until last. This method avoids pain and the resulting muscle rigidity that would obscure deep palpation later in the examination.
a.i.1. Muscle guarding
a.i.2. Rigidity
a.i.3. Large masses
a.i.4. Tenderness
b. Deep palpation
b.i. Using the same technique described for light palpation, but push down about 5 to 8 cm (2 to 3 inches) Moving clockwise, explore the entire abdomen.
b.ii. To overcome the resistance of a very large or obese abdomen, use a bimanual technique. Place your two hands on top of each other (Fig. 21-23). The top hand does the pushing; the bottom hand is relaxed and can concentrate on the sense of palpation. With either technique, note the location, size, consistency, and mobility of any palpable organs and the presence of any abnormal enlargement, tenderness, or masses.
3. Technique for examining a tender abdomen
a. To help patient relax, place a pillow under their knees, warm your hands and the stethoscope, and use a soothing voice. Also, have them give medical history to you in
1. Aortic pulsation
a. Normally, you may see the pulsations from the aorta beneath the skin in the epigastric area, particularly in thin persons with good muscle wall relaxation.
b. Marked pulsation of aorta occurs with widened pulse pressure (e.g., hypertension, aortic insufficiency, thyrotoxicosis) and with aortic aneurysm.
c. lateral pulsation with aortic aneurysm pushes the examiner's two fingers apart.
2. Light vs. deep palpation
a. Light palpation
a.i. With the first four fingers close together, depress the skin about 1 cm. Make a gentle rotary motion, sliding the fingers and skin together. Then lift the fingers (do not drag them) and move clockwise to the next location around the abdomen. The objective here is not to search for organs but to form an overall impression of the skin surface and superficial musculature. Save the examination of any identified tender areas until last. This method avoids pain and the resulting muscle rigidity that would obscure deep palpation later in the examination.
a.i.1. Muscle guarding
a.i.2. Rigidity
a.i.3. Large masses
a.i.4. Tenderness
b. Deep palpation
b.i. Using the same technique described for light palpation, but push down about 5 to 8 cm (2 to 3 inches) Moving clockwise, explore the entire abdomen.
b.ii. To overcome the resistance of a very large or obese abdomen, use a bimanual technique. Place your two hands on top of each other (Fig. 21-23). The top hand does the pushing; the bottom hand is relaxed and can concentrate on the sense of palpation. With either technique, note the location, size, consistency, and mobility of any palpable organs and the presence of any abnormal enlargement, tenderness, or masses.
3. Technique for examining a tender abdomen
a. To help patient relax, place a pillow under their knees, warm your hands and the stethoscope, and use a soothing voice. Also, have them give medical history to you in