Abdominal Assessment

Lisa Pezik, RN, BScNClinical Educator

Objectives

Review basic anatomy of the abdominal system.

Discuss assessment techniques.

Critically think through common problems.

Discuss treatment plans for these problems.

GI System Gastrointestinal System

30 Feet Long

Muscles, vessels, organs

From mouth to anus

Turns food into energy, growth, cell repair

Hormones of digestion

Gastrin

Secretin

Cholecystokinin

Gastric inhibitory peptide

Hormones

Digestion

Outside Muscles

Inside Muscles Muscles

Support the abdominal cavity

Protect organs

Weakness leads to: Hernias

Distention

Postural problems

Back pain

Risk of Falls

Vessels Arteries carry oxygenated blood away from

the heart.

Veins carry de-oxygenated blood to the heart.

Organs Upper GI

Esophagus

Pancreas

Gallbladder

Stomach

Spleen

Liver

Duodenum

Lower GI Small Intestine

Large Intestine

Appendix

Functions of The Organs

Esophagus Carries liquids and saliva to the stomach

Pancreas Digestive enzymes to control insulin and

glucagon

Stomach Secretes enzymes to digest food

Muscles churn to process food

Pyloric sphincter pushes food to the small intestine

Functions of the Organs

Spleen Stores and produces lymphocytes to aid immunity

Gallbladder Aids in fat digestion and stores bile

Liver Bile production

Immune functions

Blood clotting

Stores sugar

Metabolizes drugs

Functions of the Organs

Small intestine Chemical digestion occurs

Absorbs nutrients

21 feet long

Large intestine Absorbs water and lubricates contents

Neutralizes acids and bacteria

5 feet long

Appendix 4 inches long

Junction of small and large intestine

Stores good bacteria in the gut?

Assessment Basics

Inspection

Auscultation

Percussion

Palpation

Inspection and Palpation

Look for distention or un-evenness of the umbilicus

Palpate 1cm for any painful areas

Measure abdominal growth if applicable

Organs Per Quadrant

Auscultation Where to begin

Start in RUQ and listen 2 minutes in each quadrant

Absent, hypo/hyper/normoactive

Normal sounds in the small intestine High pitched and gurgling

Normal sounds in the large intestine Low pitched and rumbling

Normal Rate 5-35 sounds a minute

Percussion Percuss all quadrants for dullness

Percuss for tympany Low drum like sound caused by gas

Percuss for hyper-ressonance Increased lower pitch due to distended bowel

Percuss bladder volume Fullness causes pressure upwards

Interpretation of Results

Constipation Mild Concern

Inability to pass stool, hard stool, or self impaction

Complaints of fullness

Can cause hemorrhoids

Constipation Moderate Concern

Leaking, small stools

Cramping, bloating

Straining

Blood tinged stool

Vomiting

Fecal impaction

A large lump of dry stool

Caused by chronic constipation

Stool

Constipation Severe Concern

Bowel Obstruction

Complete blockage of the small and large intestines

Distended tympanic abdomen

Tachypnea, Tachycardia, Low BP

Cramping, Pain, Tenderness

Vomiting

Diarrhea

Bloody Stools

Absent or hyperactive bowel sounds

Small Bowel Obstruction

Large Bowel Obstruction

Ascites Build up of fluid in the abdomen

High pressure in the blood vessels of the liver

Low levels of albumin

Caused by: Cancer

Liver failure

Pancreatitis

CHF

Portal Vein Thrombosis

Peritonitis Inflammation of the peritoneum causing

severe pain

Points to Ponder Pain = Inflammation

Dullness with percussion = Fullness of normal OR abnormal structure

Crepitus = Diverticulitis or organ perforation

Bruising = Hemorrhage or injury

Questions?