GU HA GI

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Author:
MeganM
ID:
309637
Filename:
GU HA GI
Updated:
2015-10-19 12:15:50
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Health Assessment GI Siedel Advanced FNP
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GU,HA
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GU Adv HA GI CH 17 Seidel
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  1. Where does the hepatic artery transport blood to and from?
    from the aorta to the liver
  2. Where does the portal vein carry blood to and from?
    from the digestive tract and spleen to the liver
  3. Where is the liver located?
    • RUQ
    • below diaphragm
    • above gb, rt kidney, & hepatic flexure of colon
  4. Where do the 3 hepatic veins carry blood?
    fro the liver and empty into the IVC
  5. What is gluconeogensis? Where does this happen?
    The process of converting amino acids to glucose (in the liver)
  6. What does the liver do with cholesterol?
    uses it to form bile salts
  7. In the liver, what is made from carbs and proteins?
    fats
  8. What happens to proteins in the liver?
    They are broken down into amino acids by hydrolysis and then their waste products are converted to urea for excretion
  9. The liver stores ______.
    glucose, vitamins, and iron
  10. The liver produces _______.
    • antibodies,
    • coagulation substances
    • plasma proteins
    • also synthesizes bile
  11. What two ducts form the common bile duct?
    cystic and hepatic
  12. How does the pancreas act as an endocrine gland?
    islet cells produce insulin and glucagon
  13. How does the pancreas act as an exocrine gland?
    • acinar cells produce digestive enzymes
    • pancreatic duct empties into duodenum at the duodenal papilla
  14. Where is the spleen?
    • LUQ
    • above left kidney
    • below diaphragm
  15. Each kidney extends from the vertebral level of _____ to ______.
    T12 to L3
  16. The _____ kidney is usually slightly lower than the ______.
    • right
    • left
  17. How do the kidneys act as endocrine glands?
    • produces renin, which controls aldosterone secretion
    • is primary source of EPO production in adults
    • synthesizes prostaglandins
    • produces biologically active form of vit D
  18. Dullness extending above the fifth intercostal space suggests?
    upward displacement of the liver due to abdominal fluid or masses
  19. What organs are in the LUQ?
    spleen and stomach
  20. What organs are in the RUQ?
    • liver
    • gb
  21. What organs are in the LLQ?
    ascending colon
  22. What organs are in the RLQ?
    appendix
  23. What is Murphey's sign used to test?
    gallbladder inflammation
  24. In older adults, hepatic BF decreases as a result of?
    decline in CO
  25. The size of the ________ is unaffected by aging
    pancreas
  26. The _______ cells of the pancrease produce enzymes.
    acinar
  27. What is a Cullen sign and what does it suggest?
    • bluish periumbilical discoloration
    • intraabdominal bleeding
  28. What may be the first sign of an intraabdominal malignancy?
    • Sister Mary Joseph's Nodule
    • (a pearl-like, enlarged and sometimes painful umbilical nodule)
  29. A __________ contour is characteristic of young children, but in adults it is the result of fat or poor muscle tone.
    rounded or convex
  30. Males exhibit primarily ______ movement with respiration, whereas females show mostly ______ movement.
    • abdominal
    • costal
  31. Normal rate of bowel sounds
    5-35 per minute
  32. What does a high-pitched tinkling sound in the bowel suggest?
    intestinal fluid and air under pressure (early obstruction)
  33. Decreased BS occur with ______ and paralytic ileus.
    peritonitis
  34. Listen with the diaphragm for friction rubs over the _______.
    liver and spleen
  35. What may a bruit indicate?j Where do you listen for one?
    • vascular disease
    • epigastric region (with bell) in aortic, renal, iliac, and femoral arteries
  36. A lower liver border more than ______ below the costal margin may indicate organ enlargement or downward displacement of the diaphragm.
    2-3cm (3/4 to 1 in)
  37. The upper border of the liver is usually where?
    fifth right ICS
  38. An upper border below the 5th ICS may indicate?
    downward displacent or liver atrophy
  39. Dullness extending above the 5th right ICS suggests?
    • upward displacement or 
    • abdominal fluid or masses
  40. Liver span is usually greater in _____ and ______.
    • males
    • tall people
  41. Normal liver span at midsternal line
    4-8 cm (1 1/2 to 3 in)
  42. What is Traube's space?
    • a semilunar region 
    • 6th rib superiorly
    • midaxillary line laterally
    • left costal margin inferiorly
  43. With splenic enlargement, tympany changes to dullness as the spleen is brought _____ with INSPIRATION.
    forward and downward
  44. Light palpation is useful in identifying ___________.
    • muscular resistance & 
    • areas of tenderness
  45. Moderate palpation with the side of the hand is useful in assessing which organs?
    • liver & spleen
    • (they move with respiration)
  46. During INSPIRATION, the liver and spleen are displaced _________.
    downward
  47. When might the scratch test for the liver be useful?
    if the abdomen is distended or the abdominal muscles tense
  48. A palpable, TENDER gallbladder indicates ______; whereas NONTENDER enlargement suggests ___________.
    • cholecystitis
    • common bile duct obstruction
  49. The ______ kidney is more commonly palpable, wherease the ______ kidney is not normally palpable.
    • right
    • left
  50. A prominent _______ pulsation suggests an AAA.
    lateral
  51. What is the Alvarado score?
    • a pain assessment tool for appendicitis (MANTRELS)
    • Migration of pain
    • Anorexia
    • N/V
    • Tenderness in the RLQ
    • Rebound pain
    • Elevation of temp
    • Leukocytosis
    • Shift to the Left
  52. What is a positive Blumberg sign?
    Rebound tenderness causing a sharp pain at the site of peritoneal inflammation
  53. What is a positive McBurney sign?
    rebound tenderness in the LRQ (over McBurney's point) and suggests appendicitis
  54. When is the Iliopsoas Muscle Test performed?
    • When there is suspected appendicitis b/c an inflamed appendix may cause irritation of the lateral iliopsoas muscle.
  55. When is the obturator muscle test performed
    • When a ruptured appendic or pelvic abscess is suspected due to irritation of obturator muscle
    • Pain in rt hypogastric region is a positive sign
  56. What is McBurney's point?
    over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel)
  57. What does a scaphoid abdomen in a newborn suggest?
    abdominal contents are displaced into the thorax
  58. Pulsations in the ______ area are common in newborns & infants.
    epigastric
  59. When are superficial veins visible in an infant?
    when the infant is thin
  60. Are distended veins across the abdomen an expected finding in a newborn or infant?
    NO! Suggests vascular or abdominal obstruction
  61. What is diastasis rectus abdomens?
    • a separation 1-4 cm wide in midline, usually b/w xiphoid and umbilicus in infants
    • common when muscles do not approximate ea other
  62. When is the spleen palpable in infants?
    first few weeks after birth
  63. What would cause an enlarged liver in a newborn?
    Mom with DM
  64. Where may the liver edge be palpable in infants and toddlers?
    1-3 cm below the right costal margin
  65. Before 2 yo, _____ have a slightly LARGER liver span than _____.
    • females
    • males
  66. When can the olive-shaped mass of pyloric stenosis be detected in an infant?
    with deep palpation in RUQ after he/she vomits
  67. Localized epigastric pain when stomach is empty; pain is relieved by FOOD or antacids.
    duodenal ulcer
  68. Epigastric pain/heartburn that worsens when lying down.
    hiatal hernia w/ esophagitis
  69. What is a positive Kehr sign?
    • pain in LUQ that radiates to left shoulder 
    • symptom of spleen laceration/rupture
  70. When are Cullen and Grey Turner signs noted?
    In severe necrotizing pancreatitis
  71. What to suspect if s/s of pyelonephritis (chills, fever, dysuria, flank pain) persist beyond 72 hrs of abx therapy.
    Renal abscess
  72. What is a positive Dance sign?
    • *RLQ feels empty*
    • (sausage-shaped mass may be palpated in RUQ or LUQ as in Intussusception)

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