Sherpath: Chapter 22, Abdomen: Findings for the Abdomen

Question 1 of 15

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Which image indicates the normal flow of venous blood?

• Correct
  • AA represents the normal and expected flow of blood. Above the umbilicus, venous return should be toward the head; below the umbilicus, it should be toward the feet.
• • BB is an unexpected blood flow, suggestive of portal hypertension.
• • CC is an unexpected blood flow, suggestive of inferior vena cava obstruction.
• • DD is an unexpected blood flow and is cause for concern.

Question 2 of 15

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On auscultation of bowel sounds, 5 to __ occur every minute.

• • Your answer: 35Correct answer: 355-35 bowel sounds can be auscultated per minute.

Question 3 of 15

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Match the contour of the abdomen with the type of patient for which it would normally be expected.

• A 25-year-old gymnast
• A 5-year-old child
• A 35-year-old patient with anorexia

Question 4 of 15

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Match the percussion note to the location over which it is expected to be found.

• Kidney
• Lung
• Abdomen

Question 5 of 15

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Match the organ with the area over which it should be percussed.

• Fifth intercostal space
• Posterior to the left midaxillary line
• Left epigastric region

Question 6 of 15

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Which findings would be expected on palpation of a healthy abdomen?

• • Immobile inguinal lymph nodesThe inguinal lymph nodes should be mobile.
• • Rough inguinal lymph nodesThe inguinal lymph nodes should be smooth.
• Correct
  • Inguinal lymph nodes 0.7 cm in diameterInguinal lymph nodes <1.0 cm in diameter are an expected finding.
• • Tenderness on deep palpation but not light palpationThere should be no tenderness on deep or light palpation.

Question 7 of 15

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In which way do the abdominal percussion findings in infants differ from those of adults?

• • Relatively larger organsThe organs of infants are not relatively larger than those of adults.
• Correct
  • More tympanyThe abdomen may produce more tympany on percussion than that found in adults because infants swallow air when feeding or crying.
• • Convex abdomenAlthough the abdomen of an infant may be convex, this is an inspection, not a percussion, finding.
• • Increased dullnessThe abdomen of an infant would not be expected to have increased dullness on percussion.

Question 8 of 15

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On evaluation of pulsations in an infant’s abdomen, which findings would be considered normal?

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  • Superficial veinsSuperficial veins are an expected finding in a thin infant.
• • Distended veinsDistended veins are an abnormal finding and suggest vascular obstruction.
• Correct
  • Inverted umbilicusThe umbilicus is expected to be inverted.
• Correct
  • Epigastric pulsationsPulsations in the epigastric area are an expected finding in newborns and infants.
• • Spider neviSpider nevi are an abnormal finding and may indicate liver disease.

Question 9 of 15

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Match the liver span with the age at which it is considered normal.

• 6 months
• 12 months
• 4 years
• 10 years

Question 10 of 15

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Which change related to the liver would be expected in a 65-year-old patient compared with a younger patient?

• • Hyperresonant liver on percussionAn older patient would not be expected to have a hyperresonant liver on percussion.
• • Larger liver weightAn older patient would not be expected to have a larger liver weight.
• • Displacement of the liverThe liver of an older patient would not be expected to be displaced.
• Correct
  • A smaller liver spanAn older patient would be expected to have a smaller midclavicular liver span.

Question 11 of 15

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Which abdominal percussion finding is common in adults with chronic obstructive pulmonary disease (COPD)?

• • Tenderness on palpationTenderness on palpation would not be expected to change from dullness to resonance in an adult with COPD.
• • Resonance on percussionPercussion over the liver would not be expected to change from dullness to resonance in an adult with COPD.
• Correct
  • Displacement of the liver bordersIn an adult with COPD, both the upper and lower borders of the liver may be detected 1 to 2 cm below the usual markers.
• • Liver span of 15 cmThe liver span of an older adult with COPD would be expected to be between 6 and 12 cm, not 15 cm.

Question 12 of 15

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Constipation may be indicated by which percussion finding, common in older adults?

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  • TympanyTympany on percussion is indicative of constipation.
• • ResonanceConstipation is not indicated by resonance on percussion.
• • Hyper-resonanceConstipation is not indicated by hyper-resonance on percussion.
• • DullnessConstipation is not indicated by dullness on percussion.

Question 13 of 15

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Which findings would be considered abnormal during auscultation of bowel sounds?

• • Irregular clicksIrregular bowel sounds are an expected finding.
• Correct
  • 50 gurgles per minute50 gurgles per minute would be unexpected; 5 to 35 bowel sounds per minute are expected.
• • Increased bowel sounds related to hungerBowel sounds are expected to increase when the patient is hungry.
• • Abdominal rigidityRigidity is a palpation finding, not an auscultation finding.

Question 14 of 15

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Which findings are considered abnormal on deep palpation of the abdomen?

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  • BulgesBulges on palpation are an abnormal finding.
• • Tenderness over cecumTenderness over the cecum may occur with deep palpation.
• • Movement of abdominal wallThe abdominal wall may feel as though it is sliding back and forth on deep palpation, but it is not considered abnormal.
• • Abdominal tensionAbdominal tension may result from deep palpation of the abdomen, but it is not considered abnormal.

Question 15 of 15

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Which findings related to percussion of the liver would be considered abnormal?

• • Liver span of 10 cmThe liver is expected to have a span of 6 to 12 cm.
• Correct
  • Lower liver border 4 cm below the costal marginA lower liver border > 2 to 3 cm below the costal margin is an abnormal finding.
• • Upper liver border at the 5th intercostal spaceThe upper liver border is expected to begin above the 5th or below the 7th intercostal space.
• • Lower liver border at the costal marginThe lower liver border is expected to be at or slightly below the costal margin.