A 62-year-old white male whose chief complaint is abdominal discomfort is admitted to your unit. The patient is jaundiced and has an enlarged abdomen
Upon percussing the patient's abdomen, you determine that ascites is present on the basis of which finding? a. hyperresonance to percussion in the left lower quadrant
b. change from tympany to resonance as you percuss each quadrant of the abdomen
c. dullness detected in the right upper quadrant
d. shift in location of the areas of dullness as he turns from side to side
D
Ascites is present if there is a marked change from tympany to dullness as you percuss outward and downward and as the patient turns from side to side. Ascitic fluid sinks with gravity, which accounts for the dullness in dependent areas. Ascites is an excess accumulation of fluid in the abdominal cavity and is found in patients with cirrhosis or other liver diseases. The presence of air in the abdomen produces a higher-pitched, hollow sound called tympany. The presence of fluid or masses produces a short, high-pitched sound with little resonance called dullness. Tympany is the predominant percussion sound of the abdomen. Hyperresonance is present with gaseous distention.
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