Duodenal atresia physical examination: Difference between revisions

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{{Duodenal atresia}}
{{Duodenal atresia}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{HQ}}


==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Common physical examination findings of duodenal atresia include [[Abdomen|abdominal]] [[distension]], [[dehydration]], and [[Agitation (emotion)|restlessness]].


OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
==Physical Examination==
==Physical Examination==


*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*Physical examination of patients with duodenal atresia is usually remarkable for: [[Abdomen|Abdominal]] [[distension]], [[dehydration]], and [[Agitation (emotion)|restlessness]].<ref name="FreemanTorfs2009">{{cite journal|last1=Freeman|first1=SB|last2=Torfs|first2=CP|last3=Romitti|first3=PA|last4=Royle|first4=MH|last5=Druschel|first5=C|last6=Hobbs|first6=CA|last7=Sherman|first7=SL|title=Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects|journal=Clinical Genetics|volume=75|issue=2|year=2009|pages=180–184|issn=00099163|doi=10.1111/j.1399-0004.2008.01110.x}}</ref><ref name="MorrisKennedy2016">{{cite journal|last1=Morris|first1=Grant|last2=Kennedy|first2=Alfred|last3=Cochran|first3=William|title=Small Bowel Congenital Anomalies: a Review and Update|journal=Current Gastroenterology Reports|volume=18|issue=4|year=2016|issn=1522-8037|doi=10.1007/s11894-016-0490-4}}</ref><ref name="AdamsStanton2014">{{cite journal|last1=Adams|first1=Stephen D.|last2=Stanton|first2=Michael P.|title=Malrotation and intestinal atresias|journal=Early Human Development|volume=90|issue=12|year=2014|pages=921–925|issn=03783782|doi=10.1016/j.earlhumdev.2014.09.017}}</ref>
*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
*Patients with duodenal atresia usually appear [[Agitation (emotion)|restless]], and [[Irritation|irritable]].  


===Vital Signs===
===Vital Signs===
*[[Tachycardia]] with regular pulse
*[[Tachycardia]] with regular pulse
===Skin===
===Skin===
*Increased skin turgor
*Increased [[skin]] [[Turgor pressure|turgor]]
 
*Dry skin
<gallery widths=150px>
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* Abnormalities of the head/hair may include ___
* [[Xerostomia|Dry mouth]]
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]  
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae


===Neck===
===Neck===
*[[Jugular venous distension]]
*No [[neck]] abnormalities present
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Asymmetric chest expansion / Decreased chest expansion
* Clear breath sounds bilaterally
*Lungs are hypo/hyperresonant
* No [[Wheeze|wheezes]]
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
* No [[Rales|crackles]]
*Rhonchi
*Vesicular breath sounds / Distant breath sounds
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
*Chest tenderness upon palpation
*Normal S1 S2
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*No [[Heart murmur|murmurs]]
*[[Heave]] / [[thrill]]
*No rubs
*[[Friction rub]]
*No [[Gallop rhythm|gallops]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope


===Abdomen===
===Abdomen===
*[[Abdominal distention]]  
*[[Abdominal distention]]  
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Abdominal tenderness]]  
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
===Back===
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Normal
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
*A pelvic/adnexal mass may be palpated
*Normal
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge


===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
*Normal
* Altered mental status
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)


===Extremities===
===Extremities===
*[[Clubbing]]
*Normal
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity


==References==
==References==
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{{WH}}
{{WH}}
{{WS}}
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[[Category: (name of the system)]]
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Disease]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]

Latest revision as of 14:38, 3 January 2018

Duodenal Atresia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Common physical examination findings of duodenal atresia include abdominal distension, dehydration, and restlessness.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

  • No neck abnormalities present

Lungs

Heart

Abdomen

Back

  • Normal

Genitourinary

  • Normal

Neuromuscular

  • Normal

Extremities

  • Normal

References

  1. ↑ Freeman, SB; Torfs, CP; Romitti, PA; Royle, MH; Druschel, C; Hobbs, CA; Sherman, SL (2009). "Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects". Clinical Genetics. 75 (2): 180–184. doi:10.1111/j.1399-0004.2008.01110.x. ISSN 0009-9163.
  2. ↑ Morris, Grant; Kennedy, Alfred; Cochran, William (2016). "Small Bowel Congenital Anomalies: a Review and Update". Current Gastroenterology Reports. 18 (4). doi:10.1007/s11894-016-0490-4. ISSN 1522-8037.
  3. ↑ Adams, Stephen D.; Stanton, Michael P. (2014). "Malrotation and intestinal atresias". Early Human Development. 90 (12): 921–925. doi:10.1016/j.earlhumdev.2014.09.017. ISSN 0378-3782.

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