This document provides information on assessing the abdomen, anus, and rectum. It discusses the key components of the examination, including inspection, auscultation, percussion, and palpation. Inspection involves observing the abdomen for signs like scars, striae, jaundice, and hernias. Auscultation listens for bowel sounds and bruits. Percussion determines the liver and spleen size and checks for fluid. Palpation feels the abdomen for masses, tenderness, guarding, and rigidity. The rectal examination and specific assessment findings are also outlined.
In this PPT presentation I try to teach many causes of Abdominal pain in various quadrants of the abdomen. Since it is individual case based teaching i concentrate only in the essential minimum an undergraduate medical student should know and you will have immersive learning experience.
In this PPT presentation I try to teach many causes of Abdominal pain in various quadrants of the abdomen. Since it is individual case based teaching i concentrate only in the essential minimum an undergraduate medical student should know and you will have immersive learning experience.
This presentation gives general overview of all aspects of bowel sounds including its pathophysiology, auscultation techniques and features of normal versus abnormal bowel sounds.
DIGITAL RECTAL EXAMINATION- Skill Lab- OSCE
#digitalrectalexamination #surgicaleducator #babysurgeon #skilllab #osce
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
Dear viewers,
• Greetings from “Surgical Educator”
• Today I am uploading one more video on Skill Lab procedure for your OSCE exam.
• In this episode, I am talking about the DRE- Digital Rectal Examination , the skill which should be mastered by all medical students.
• I hope you can master the skill by watching this video and can do all the steps in the correct sequence.
• You can enjoy all my videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
Right iliac fossa mass is a common clinical presentation and has a range of differentials that need to be excluded.
In this presentation will discuss RIF masses in briefly.
contact me / dr.3shaq@gmail.com
This presentation gives general overview of all aspects of bowel sounds including its pathophysiology, auscultation techniques and features of normal versus abnormal bowel sounds.
DIGITAL RECTAL EXAMINATION- Skill Lab- OSCE
#digitalrectalexamination #surgicaleducator #babysurgeon #skilllab #osce
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
Dear viewers,
• Greetings from “Surgical Educator”
• Today I am uploading one more video on Skill Lab procedure for your OSCE exam.
• In this episode, I am talking about the DRE- Digital Rectal Examination , the skill which should be mastered by all medical students.
• I hope you can master the skill by watching this video and can do all the steps in the correct sequence.
• You can enjoy all my videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
Right iliac fossa mass is a common clinical presentation and has a range of differentials that need to be excluded.
In this presentation will discuss RIF masses in briefly.
contact me / dr.3shaq@gmail.com
Abdominal Assessment.power point presentationsadiaahmad30
Provide reliable information for abdominal assessment related things and description.
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CHRONIC LIVER DISEASE, CLD, is characterized by chronic abnormal functioning of liver due to various causes including hepatitis, alcoholic liver disease, non-alcoholic liver disease, autoimmune and certain medications.
visit https://surgio.info/chronic-liver-disease/ for a complete case.
Similar to Monday final abdominal examination final ppt (20)
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
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Monday final abdominal examination final ppt
1. ASSESSMENT OF THE ABDOMEN, ANUS & RECTUM
Prepared By: Roheeda Riaz Khan
MSN,INS,KMU
2. LEARNING OBJECTIVES
At the completion of this unit learners will be
able to:
1. Discuss the pertinent health history questions
necessary to perform the assessment of
Abdomen, Anus and Rectum.
2. Describe the specific assessment to be made
during the physical examination of the abdomen.
7/28/2019
3. OBJECTIVES
3. Discuss components of a rectal examination.
4. Document findings.
5. List the changes in abdomen that are
characteristics of aging process.
7/28/2019
4. EXAMINATION
The order for examining the abdomen is:
Inspection, auscultation, percussion,
palpation
1) INSPECTION
2) AUSCULTATION
3) PERCUSSION
4) PALPATION
5. THE FOUR QUADRANTS
Physicians locate findings in the abdomen in one of four
quadrants or one of nine regions.
The four quadrants are:
8. INSPECTION
Signs of liver disease:
Jaundice (yellow cast to skin)
Spider angiomas: subcutaneous vessels that look
like spiders. They fill from the center when
pressed.
The liver enlarges early, later shrinks with
cirrhosis
Prominent veins at umbilicus
Hemorrhoids & Ascites
9. SOME COMMON FINDINGS ON ABDOMINAL
INSPECTION
Scars
Striae (stretch marks)
Colors
Jaundice
Prominent veins
10. SCARS
Explain every scar. Each one is evidence
of surgery or injury that the patient may
have forgotten to mention to you.
The injury that caused a visible scar may
have also caused internal scarring
(grips) - which can cause intestinal
obstruction
11. STRIAE (Stretch Marks)
On the abdomen may be a
sign of past weight changes,
such as pregnancy.
An endocrine disease,
Cushing's disease , may
cause purple Striae.
12. COLORS
Bluish color at the umbilicus is
Cullen's sign - a sign of bleeding in
the peritoneum.
Bruises on the flanks are Grey
Turner's sign (retroperitoneal
bleeding - e.g. from inflamed
pancreas)
13. PROMINENT VEINS
Prominent veins may be due to portal vein
obstruction or inferior vena cava obstruction.
The portal veins and systemic veins connect in
3 locations; the umbilicus is one of it.
14. OTHER FINDINGS ON INSPECTION: PERISTALSIS
AND SCAPHOID ABDOMEN
Visible peristalsis is usually abnormal, unless
the patient is emaciated.(shrunken)
Otherwise, it is a sign of intestinal
obstruction.
In thin adults, the abdomen may be concave
- scaphoid
15. HERNIAS
Not all hernias happen in the inguinal area. Some
abdominal hernias include:
Umbilical hernias: protrude out of the umbilicus
Incisional hernias: occur at old scars
Diastasis recti: this is not a true hernia, but a
separation of the rectus abdominal muscles. You
can see this best by asking the patient to tighten the
abdominal muscles (lift head when supine, or sit
up).
17. STAY, LOOK AND LISTEN
Always auscultate before touching the abdomen .
Touching the abdomen, even to percuss, may change
the bowel sounds.
Before you proceed, consider your patient's comfort. Is
your stethoscope warm? Are your hands warm? Are
your fingernails short? Has the patient emptied
his/her bladder?
Place a pillow under your patient's head. Asking your
patient to bend his/her knees may help relax the
abdominal muscles.
18. GUT SOUNDS
Use the diaphragm of your stethoscope to
listen to gut sounds
Normal gut sounds are gurgling, 5 to 35 per
minute
Borborygmi: Are loud, easily audible sounds.
They are normal, too.
High pitched : Tinkling (raindrops in a barrel)
sounds are a sign of early intestinal
obstruction
19. GUT SOUND
Decreased sounds: (none for a minute) are a sign of
decreased gut activity. Gut sounds may be markedly
decreased after abdominal surgery; abdominal
infection (peritonitis) or injury.
Absent Sounds : (no sounds for 5 minutes) are a bad
sign. They can be caused by longer-lasting intestinal
obstruction, intestinal perforation or intestinal
(mesenteric) ischemia or infarction.
Mesenteric ischemia is a medical condition in which injury to the small
intestine occurs due to not enough blood supply. It can come on suddenly,
known as acute mesenteric ischemia, or gradually, known as chronic
mesenteric ischemia.
20. BRUITS
Aortic bruits: Are heard in the epigastrium.
They may be a sign of abdominal aortic
aneurysm;
Renal artery bruits: Are in each upper
quadrant. They may be a sign of renal artery
stenosis, which is a potentially treatable cause
of hypertension;
Iliac/femoral bruits: Are in the lower
quadrants. They may be a sign of peripheral
atherosclerosis.
21.
22. CASE 1
A 50 year old man has nausea and vomiting for two
days and no bowel movement. His abdomen is
somewhat distended.
Does he have intestinal obstruction ?
Signs of intestinal obstruction are:
High-pitched tinkling bowel sounds
Later: bowel sounds absent
Visible peristalsis
24. PERCUSSION
What is to finds?: liver size , spleen, fluid.
PERCUSSING THE BODY GIVES ONE OF THREE
NOTES:
Tympany: is found in most of the abdomen, caused
by air in the gut. It has a higher pitch than the
lung.
Resonance: is found in normal lung. It is lower
pitched and hollow.
Dullness: is a flat sound, without echoes. The liver
and spleen, and fluid in the peritoneum (ascites),
give a dull note.
25. PERCUSSING OF LIVER and SPLEEN
A normal liver measures 6
to 12cm, usually 8 to
12cm.
The reliability of percussion
to assess liver size is
limited
(Am J Gastroenterology 1995; 90:1428-32)
26. Cont.…
To percuss the spleen :
Percuss in left anterior axillary line, just above
lowest rib.
Ask your patient to take a deep breath and
percuss again. Dullness with full inspiration
may be a sign of enlarged spleen.
(splenomegaly)
27. CASE 2
A 55 year old women with a distended
abdomen
She drinks half of cup daily and notes gradually
increasing abdominal girth. She has no pain.
Does she have ascites (fluid) caused by liver
failure?
28. USING PERCUSSION to DIAGNOSE ASCITES
Physical signs of ascites include fluid wave,
shifting dullness and puddle sign( lake,
Pool). Two of these are done by percussion.
Shifting dullness : Start with your patient
supine. Percuss down the lumbar area
closest to you; mark the point where note
turns dull.
Now turn the patient onto his/her side facing
you and percuss down again. If the dull
area is now higher (closer to the
umbilicus), this suggests fluid in the
peritoneum (ascites).
29. CONT…..
Puddle sign (rarely done): Patient is on all
fours, (hands and knees)
Percuss for a dull area around the umbilicus
(lowest point)
Grading of puddle signs
TEST Minimal Fluid In ML
Diagnostic Tape 10-20ml
Ultra Sound 100ml
CT Scan 100ml
Puddle signs 120ml
Shifting 500ml
Fluids thrill 1000-1500ml
30.
31. PERCUSSION FOR RENAL ANGLE TENDERNESS
To look for renal causes of
pain, such as
pyelonephritis (kidney
infection), you may
percuss the back in the
region of the costo-phrenic
angle. Tenderness on one
side may come from that
kidney.
33. PALPATION
Use palpation to assess:
Liver, spleen and kidneys for enlargement and
consistency .Masses .Tenderness .Spasm of abdominal
muscles
Guarding= spasm, when you push; sign of tenderness
or inflammation
Rigidity= board-like spasm all the time; sign of bad
things like perforated intestine, dead intestine from
lack of circulation (infarction), or diffuse infection
peritonitis.
Oversensitivity of skin = cutaneous hyperesthesia: a sign
of inflammation of underlying structure
34. PALPATION TECHNIQUE
Warm hands; use two hands and
focus on what your lower hand
feels.
Bend your patient's knees to relax
abdominal muscles
If the patient is ticklish, include
patient's hand between your
two hands - a "hand sandwich"
Examine tender areas last
35. PALPATION OF LIVER
Some hints:
Push in fairly deeply, 5cm deep or more
Inch your right hand up toward the
patient's lower costal margin with
each breath.
The liver edge should be palpable, if at
all, at the lower costal margin. It
should feel rubbery and smooth
36. PALPATION OF THE KIDNEYS
Palpation of the kidneys :
• Kidneys are usually not palpable in
adults unless quite enlarged (e.g.
polycystic)
• The right is palpable more often than
the left
• Kidneys are deep in the flank and move
down with inspiration.
Palpation for masses :
Use deep pressure with the palmar aspect
of your fingers, with a rolling motion.
37. CASE 3: What is that lump?
You feel a mass when palpating your
fellow student's abdomen.
Normal "masses" include:
Feces in the sigmoid colon (often
slightly tender)
Distended bladder
The uterus (e.g. pregnant)
The aorta (it's pulsation).
38. AAA
Aorta is just to the left of the midline
and is pulsatile
If it seems 5 cm or wider: evaluate
for abdominal aortic aneurysm .
39. HOW SENSITIVE IS PALPATION FOR
DETECTING ABDOMINAL AORTIC ANEURISM?
Aneurysms require surgery if larger
than 5cm. Examination for
abdominal aortic aneurysm (AAA)
has sensitivity of:
82% if patient's girth is under 100 cm
(40 inches)
100% if patient's girth is under 100 cm
and aneurysm is over 5 cm
JAMA 2000; 160(6):833-836.)
40. PHYSICAL FINDINGS
Fever (often low-grade, around 38 degrees) 79% sensitive 21% of
patients are afebrile
Abdominal rigidity
Tenderness on right side on rectal examination
Rebound tenderness : Push gently until pain decreases, then lift
your hand suddenly. The pain is worse when you lift your hand - a
sign of peritoneal irritation. A kinder way to test for rebound
tenderness is called
Rovsing's sign : you push down on the non tender side of the
abdomen and lift your hand suddenly. Patient feels pain in the
affected area (RLQ) when you lift your hand.
41. The area of tenderness in appendicitis should
be Burney's point: 1/3 of the way up a
oblique line from iliac crest to the umbilicus.
Pain in RLQ near inguinal ligament in young
women is most likely pelvic (ovarian cyst,
pelvic inflammatory disease, abscess in
fallopian tube) or urinary tract and NOT
usually appendicitis.
43. Cont.……
RLQ tenderness and leukocytosis = 2 points
each ; all others 1 point
Score of 5 to 6 = possible appendicitis
Score of 7 to 8 = probable appendicitis
Score of 9 to 10 = very probable appendicitis
up to 25% under age 20 – 50+have
appendicitis
44. CAUSES of ABDOMINAL DISTENSION
Distension of the lower abdomen only can be caused by
Pregnancy.
Full bladder.
Ovarian tumor,
Uterine fibroids (common benign growths)
Diffuse abdominal distension can be caused by any of
The 6 Fs:
Feces (constipation & Fat (obesity)
Fluid (ascites - peritoneal fluid - or obstructed viscera
filled with fluid)
Flatus (air) air swallowing or intestinal obstruction
Fetus (pregnancy) & Fatal cancer and jaundice
45. USEFUL CLINICAL SIGNS of CHOLECYSTITIS
Right upper quadrant tenderness
Murphy's sign : when you push
toward the liver at the right costal
margin, patient has pain and stops
breathing:
Is a sign of gall bladder infection
(cholecystitis).
Palpable mass
51. INSPECTION OF THE ANUS
Wash hands and put on a pair of
disposable gloves
Gently separate the area and
inspect the natal cleft and anal
edge
Look for fissures,
rashes, haemorrhoids,
warts etc
The position of an anal lesion is
described in relation to the face
of a clock
The anterior aspect of the anus
is assigned to 12 o’clock
Sunday, July 28, 2019