Mesenteric ischemia physical examination: Difference between revisions
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===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients presenting with acute occlusive mesenteric ischemia are in acute distress. | *Patients presenting with acute occlusive mesenteric ischemia are in acute distress while patients with chronic mesenteric ischemia may look malnourished. | ||
===Vital Signs=== | ===Vital Signs=== | ||
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* [[Pallor]] | * [[Pallor]] | ||
===Neck=== | ===Neck=== | ||
*[[Jugular venous distension]] | *[[Jugular venous distension]] in case of congestive heart failure | ||
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope | *[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope | ||
===Lungs=== | ===Lungs=== | ||
| Line 87: | Line 59: | ||
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | *[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | ||
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test | *Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
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===Extremities=== | ===Extremities=== | ||
*[[Cyanosis]] | *[[Cyanosis]] | ||
*Pitting/non-pitting [[edema]] of the upper/lower extremities | *Pitting/non-pitting [[edema]] of the upper/lower extremities | ||
==References== | ==References== | ||
Revision as of 16:02, 22 December 2017
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Mesenteric ischemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Mesenteric ischemia physical examination On the Web |
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American Roentgen Ray Society Images of Mesenteric ischemia physical examination |
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Risk calculators and risk factors for Mesenteric ischemia physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
The presence of uncertain abdominal pain out of proportion to physical examination findings is diagnostic of mesenteric ischemia.
The presence of on physical examination is highly suggestive of [disease name].
- Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
- 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
- Patients presenting with acute occlusive mesenteric ischemia are in acute distress while patients with chronic mesenteric ischemia may look malnourished.
Vital Signs
- Tachycardia with irregular pulse
- Tachypnea
- Weak/bounding pulse
Skin
Neck
- Jugular venous distension in case of congestive heart failure
- Carotid bruits may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
Lungs
- Asymmetric chest expansion / Decreased chest expansion
- Lungs are hypo/hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- 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
- Chest tenderness upon palpation
- PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
- Heave / thrill
- Friction rub
- S1
- S2
- S3
- S4
- 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
- Abdominal distention
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- 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
Neuromuscular
- Patient is usually oriented to persons, place, and time
- 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)