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Shifting Dullness
In medicine, shifting dullness refers to a sign elicited on physical examination for ascites (fluid in the peritoneal cavity).Murray Longmore, Ian B. Wilinson, Edward H. Dawvidson, Alexander Foulkes and Ahmad R. Mafi ''Oxford Handbook of Clinical Medicine'' 8thEdition Oxford University Press 2010 The test is performed by first percussing the midline of the abdomen to elicit a resonant note due to gas in the abdomen. If there is no area of resonance, then the test cannot be performed. Percussion is then moved progressively more laterally (away from the examiner) – this is depicted as the red section in the diagram on the right – until the note becomes dull, as depicted by the green section. The examiner's index finger remains on the resonant side, and the middle finger remains on the dull side, straddling the fluid-air level. The patient is then asked to lean on their right lateral side (assuming the examiner used the traditional right-sided approach). This stabilises the pati ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, o ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sign (medicine)
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indication ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Physical Examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a diagnosis and devise the treatment plan. These data then become part of the medical record. Types Routine The ''routine physical'', also known as ''general medical examination'', ''periodic health evaluation'', ''annual physical'', ''comprehensive medical exam'', ''general health check'', ''preventive health examination'', ''medical check-up'', or simply ''medical'', is a physical examination performed on an asymptomatic patient for medical screening purposes. These are normally performed by a pediatrician, family practice physician, physician assistant, a certified nurse pr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ascites
Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis. In the developed world, the most common cause is liver cirrhosis. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Diagnosis is typically based on an examination together with ultrasound or a CT scan. Testing the fluid can help in determining the underlying cause. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with co ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Peritoneal Cavity
The peritoneal cavity is a potential space between the parietal peritoneum (the peritoneum that surrounds the abdominal wall) and visceral peritoneum (the peritoneum that surrounds the internal organs). The parietal and visceral peritonea are layers of the peritoneum named depending on their function/location. It is one of the spaces derived from the coelomic cavity of the embryo, the others being the pleural cavities around the lungs and the pericardial cavity around the heart. It is the largest serosal sac, and the largest fluid-filled cavity, in the body and secretes approximately 50 ml of fluid per day. This fluid acts as a lubricant and has anti-inflammatory properties. The peritoneal cavity is divided into two compartments – one above, and one below the transverse colon. Compartments The peritoneal cavity is divided by the transverse colon (and its mesocolon) into an upper supracolic compartment, and a lower infracolic compartment. The liver, spleen, stomach, and lesser ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Shifting Dullness
In medicine, shifting dullness refers to a sign elicited on physical examination for ascites (fluid in the peritoneal cavity).Murray Longmore, Ian B. Wilinson, Edward H. Dawvidson, Alexander Foulkes and Ahmad R. Mafi ''Oxford Handbook of Clinical Medicine'' 8thEdition Oxford University Press 2010 The test is performed by first percussing the midline of the abdomen to elicit a resonant note due to gas in the abdomen. If there is no area of resonance, then the test cannot be performed. Percussion is then moved progressively more laterally (away from the examiner) – this is depicted as the red section in the diagram on the right – until the note becomes dull, as depicted by the green section. The examiner's index finger remains on the resonant side, and the middle finger remains on the dull side, straddling the fluid-air level. The patient is then asked to lean on their right lateral side (assuming the examiner used the traditional right-sided approach). This stabilises the pati ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Percussion (medicine)
Percussion is a technique of clinical examination. Overview Percussion is a method of tapping on a surface to determine the underlying structures, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation, auscultation, and inquiry. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The nonstriking finger (known as the pleximeter) is placed firmly on the body over tissue. When percussing boney areas such as the clavicle, the pleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of tuberculosis. There are two types of percussion: direct, which uses only one or two fingers; and indirect, which uses only the middle/flexor finger. Broadly classifying, there are four types of percussion sounds: resonant, hyper-resonant, stony dull or dul ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior (anatomy), posterior tagma (biology), tagma of the body; it follows the thorax or cephalothorax. In humans, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between Lumbar vertebrae, L5 and Vertebra#Sacrum, S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear. In vertebrates, the abdomen is a large body c ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Puddle Sign
In gastroenterology, the puddle sign is a physical examination maneuver that can be used to detect the presence of ascites. It is useful for detecting small amounts of ascites—as small as 120 mL; shifting dullness and bulging flanks typically require 500 mL. The steps are outlined as follows: # Patient lies prone for 5 minutes # Patient then rises onto elbows and knees # Apply stethoscope diaphragm to most dependent part of the abdomen # Examiner repeatedly flicks near flank with finger. Continue to flick at same spot on abdomen # Move stethoscope across abdomen away from examiner # Sound loudness increases at farther edge of puddle # Sound transmission does not change when patient sits In relation to auscultatory percussion, the puddle sign is more specific, but less sensitive. See also *Abdominal examination An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of di ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Abdominal Examination
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The physical examination typically occurs after a thorough medical history is taken, that is, after the physician asks the patient the course of their symptoms. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simpl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fluid Wave Test
In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap. The pressure on the midline prevents vibrations through the abdominal wall while the fluid allows the tap to be felt on the other side. The result is considered positive if tap can be felt on the other side. However, even with the midline pressure, transmission through the skin must be excluded. A positive fluid wave test indicates that there is a free fluid (ascites) in the abdomen. When one side of the abdomen is pressed, the other side may also be painful due to the transfer of the fluid in it. See also * Abdominal examination * Bulging flanks * Puddle sign * Shifting dullness In medicine, shifting dullness refers to a sign elicited on physical examination for ascites (fluid in th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bulging Flanks
Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis. In the developed world, the most common cause is liver cirrhosis. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Diagnosis is typically based on an examination together with ultrasound or a CT scan. Testing the fluid can help in determining the underlying cause. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with co ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
