Abdomen mich

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  • 1.The digestive system or tract is basicallya long tube that begins with the mouth or oral cavity, and ends at the anus. There are five function under the digestivesystem, each function corresponds toeach organ of the systems. These are thefollowing. INGESTION, SECRETION, DIGESTION, ABSORPTION andEGESTION( DEFECATION)

2. Ingestion is the process of carrying foodinto the digestive tube through the oralcavity, organs under this process are ( oralcavity, tongue, teeth, salivary glands,esophagus). Secretion is the process wherein differentchemicals and enzymes are beingreleased by the organs to aid in digestionand absorption of nutrients, organs underthis function are( stomach, liver, gall 3. Digestion is the process wherein the foodis being process by the stomach to beabsorbed by the body, organ under thisprocess is the stomach. Absorption is the process of absorbing allthe nutrients provided by the food that isbeing ingested, organs under this processare small intestine { duodenum, jejunum,ileum } and the large intestine { appendixand colon {ascending, transverse and 4. The GI tract is a 23- to 26-foot-long pathway that extends from the mouth through the esophagus, stomach, and intestines to the anus THE FOUR BASIC TUNICS ON THE TUBE ( MUCOSA + SUBMUCOSA + MUSCULARIS + SEROSA) esophagus -is located in the mediastinum in thethoracic cavity, anterior to the spine and posterior tothe trachea and heart(25 cm long) stomach -is situated in the upper portion of theabdomen to the left of the midline, just under the leftdiaphragm. It is a distensible pouch with a capacityof approximately 1500mL. 5. Stomach- can be divided into fouranatomic regions: the cardia (entrance),fundus, body, and pylorus (outlet). small intestine- is the longest segment ofthe GI tract, accounting for about two thirdsof the total length. small intestine- is divided into threeanatomic parts: the upper part, called theduodenum; the middle part, called thejejunum; and the lower part, called the 6. ORGANS AND FUNCTIONS large intestine - consists of an ascending segment on the right side of the abdomen, a transverse segment that extends from right to left in the upper abdomen, and a descending segment on the left side of the abdomen. The terminal portion of the large intestine consists of two parts: the sigmoid colon and the rectum. The rectum is continuous with the anus. 7. The liver is situated in the top part of the abdomen on the right side of the body next to the stomach. It is the largest gland in the body, weighing almost 2 kg. is the major detoxicating organ in the body; it destroys harmful organisms in the blood, produces clotting agents, secretes bile, stores glycogen and metabolises proteins, carbohydrates and fats 8. gall bladder- a sac situated underneaththe liver, in which bile produced by the liveris stored. Pancreas- a gland which lies across theback of the body between the kidneys. Ithas two functions: the first is to secrete thepancreatic juice which goes into theduodenum and digests proteins andcarbohydrates; the second function is toproduce the hormone insulin whichregulates the use of sugar by the body 9. Spleen - an organ in the top part of theabdominal cavity behind the stomach andbelow the diaphragm, which helps todestroy old red blood cells, formlymphocytes and store blood. Appendix- a small tube attached to thecaecum which serves no function but canbecome infected, causing appendicitis. 10. ABDOMENAbdominal Quadrants 11. ABDOMENOrgans of the Abdominal Cavity 12. ABDOMENAbdominal Quadrants and the Underlying Organs 13. ABDOMEN 14. ABDOMENNine Abdominal Regions 15. ABDOMENLandmarks Commonly Used to Identify Abdominal Areas 16. ABDOMEN NORMAL FINDINGS` DEVIATION FROM NORMALInspect the abdomen Unblemished skin. Presence of rash or otherfor skin integritylesions.Uniform colorTense, glistening skinSilver-white striae (may indicate ascites,(stretch marks) oredema).surgical scarsPurple striae (associatedwith Cushings disease) 17. DEVIATION FROMABDOMEN NORMAL FINDINGSNORMALInspect the Flat, rounded (convex), Distendedabdominal or scaphoid (concave)contour (profileline from the ribmargin to thepubic bone) whilestanding at theclients side whilethe client is indorsal recumbentpositionInspect for anNo evidence of Evidence of enlargementenlarge liver orenlargement of the of the liver or spleenspleenliver or spleenAsk client to take adeep breath and holdbreath to observe fororgan enlargementsand abdominaldistention 18. DEVIATION FROM ABDOMENNORMAL FINDINGS NORMALAssess the symmetry Symmetric contour Asymmetric contourof contour while(localized protrusionsstanding at the footaround the umbilicus,of the bedinguinal ligaments, orscars) possible hernia If distention is present, or tumor.measure abdominal girth,by placing tape measurearound the umbilicus 19. DEVIATION FROMABDOMEN NORMAL FINDINGS NORMALInspect theSymmetric movements Limited movement dueabdominalcaused by respirations. to pain or diseasemovements process.associated withVisible peristalsis inrespirations,very lean people Visible peristalsis inperistalsis, or aorticnonlean clients (withpulsations Aortic pulsation in thin bowel obstruction) person at the epigastric areaObserve vascular No visible vascular Visible venous patternpatterns pattern (dilated veins) associated with liver disease, ascites and venocaval obstruction. 20. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALAuscultate theAudible bowel sounds. Absent, hypoactive, orabdomen for bowelhyperactive bowelsounds, vascularAbsence of bruits. sounds.sounds, andLoud bruit over aorticperitoneal friction Absence of friction rub. area (possiblerub. aneurysm). Bruit over renal or iliac arteries. 21. Sites for Auscultating the Abdomen 22. AUSCULTATING THE ABDOMENWarm the hands and the stethoscope diaphragms.FOR BOWEL SOUNDS Use the flat disc diaphragm. Intestinal sounds are relatively high pitched and best accentuated by the flat disc diaphragm. Ask when the client last ate. Shortly after or long after eating,bowel sounds may normally increase. They are loudest when ameal is long overdue. 4-7 hours after a meal, bowel soundsmaybe heard continuously over the ileocecal valve area while thedigestive system empty through the valve into the large intestine. Listen for active bowel sounds ---irregular gurgling noisesoccurring about every 5 to 20 seconds Normal bowel sounds are described as audible, 5-34 bowelsounds per minute High pitched, loud, rushing, sounds that occur frequently (e.g.every 3 seconds) also known as BORBORYGMI True absence of sounds (none heard in 3 to 5 minutes) indicatescessation of intestinal motility. 23. AUSCULTATING THE ABDOMEN Hypoactive bowel sounds indicate decreased motility and are usualyassociated with manipulation of the bowel during surgery, inflammation,paralytic ileus or late obstruction. Hyperactive bowel sounds indicate increased intestinal motility and areusually associated with diarrhea, an early bowel obstruction or the use odlaxativeFOR VASCULAR SOUNDS Use the bell of the stethoscope over the aorta, renal arteries, iliac arteries, and femoral arteries Listen for bruits ( blowing sound due to restricted blood flow through narrowed vessels)FOR PERITONEAL FRICTION RUB Peritoneal friction rub are rough, grating sounds like two pieces of leather rubbing together. Friction rubs may be caused by inflammation, infectious or abnormal growths 24. ABDOMEN 25. ABDOMEN 26. DEVIATION FROM ABDOMENNORMAL FINDINGSNORMALPercuss severalTympany over theLarge dull areasareas in each of the stomach and gas-filled(associated withfour quadrants.bowels; dullness, presence of fluid or especially over the liver tumor)Begin in the LLQ and spleen or fullRLQ RUQ LUQ bladder 27. ABDOMENMENNORMAL FINDINGSDEVIATION FROM NORMALPercuss span of liver Normal liver span is Firm edge of cirrhosisdullness in the 4-8 cm in midsternal Increased inmidclavicular lineline and 6-12 cm inhepatomegaly(MCL) right midclavicularline 28. ABDOMENPERCUSSING LIVER SPAN 29. ABDOMEN 4-8 cm in midsternal line6-12cm in rightmidclavicularline 30. Percussing the Area Over the Symphysis Pubis 31. DEVIATION FROM ABDOMEN NORMAL FINDINGSNORMALPerform light No tenderness, relaxed Tenderness andpalpation followed by abdomen with smooth, hypersensitivity.deep palpation of all consistent tension. Superficial masses.four quadrantsTenderness maybe Localized areas ofpresent near the increased tensionxiphoid process, over Generalized orcecum, and sigmoid localized areas ofcolon tenderness Mobile or fixed masses. 32. PALPATING THE ABDOMENLIGHT PALPATIONTo check for muscle tone and tenderness Place the hand with fingers together parallel to the area beingpalpated. Press down 1 to 2 cm. Repeat in ever-widening circles until thearea to be examined is covered. If patient is excessively ticklish, begin by pressing your hand on top ofthe clients hand while pressing lightly. Then slide your hand off theclients and onto the abdomen to continue the examination.DEEP PALPATIONTo identify abdominal organs and abdominal masses.Palpate sensitive areas last.With fingers together, approach the area to be examined at a 60 degreeangle and use the pads and tips of the fingers of one hand to press in 4cm. 33. ABDOMENLIGHT PALPATION 34. ABDOMENTWO-HANDED DEEP PALPATION 35. ABDOMENAssess for Peritoneal inflammation1. Before palpation, ask the patient to cough and determine where the cough produced pain.2. Then, palpate gently with one finger to map the tender area. Abdominal pain on coughing or with light percussionsuggests peritoneal inflammation 36. ABDOMEN3.If not, look for rebound tenderness. Press your fingers in firmly and slowly, and then quickly withdraw them.4.Watch and listen to the patient for signs of pain.5.Ask the patient (A) to compare which hurt more, the pressingor the letting go, and (B) to show you exactly where it hurt.Pain induced or increased by quick withdrawal constitutesrebound tenderness. Rebound tenderness suggests peritonealinflammat