1. Abdomen

2. Structure and Function Borders of Abdominal Cavity Lg. Oval cavity from diaphragm to pelvis Posteriorly- vertebral column & paravertebral muscles Laterally & anteriorly – lower rib cage and abdominal muscles

3. Abdominal Muscles 4 layers 1. External oblique 2. Internal oblique 3. Transverse abdominis 4. Rectus abdominus  Linea alba  Rectus abdominus

5. Internal Anatomy Viscera Liver Gallbladder Spleen Aorta Pancreas Kidneys

8. Abdominal wall = 4 quadrants RUQ LUQ RLQ LLQ Epigastric Umbilical Suprapubic

11. Subjective Data Appetite Dysphagia Food intolerance Abdominal pain N&V Bowel habits Past abd. History Medications Nutritional assessment

12. Objective Data Order of Exam Inspection Auscultation Percussion Palpation

22. Spleen

24. Rt. Kidney

25. Lt. Kidney

26. Refered abd. Pain

27. obesity Ascites Ovarion cyst Air/ Gas

28. Breasts/ Axilla

29. External Anatomy B/t 2 nd 6 th rib Sternum to MAL Tail of Spence Nipple Areola Montgomery’s glands

30. Internal Anatomy Glandular tissue 15- 20 lobes Alveoli producing milk Ducts Lactiferous Collecting Ampullae Reservoir for storing milk

31. Internal Anatomy cont. Cooper’s ligaments Adipose tissue Breast 4 quadrants Tail of Spence Most breast tumors – upper outer quadrant

35. Lymphatics Axillary nodes Central axillary Pectoral Subscapular Lateral Lymph- central axillary node- up to infraclavicular and supraclavicular nodes

36. Lymphatics cont. Small amt. Of lymph Directly to infraclavicular group Or deep into chest Or abdomen Or directly across to the opposite breast

38. Subjective Data - Breast Pain Lumps Discharge Rash Swelling Trauma History Self- care behaviors

39. Subjective Data- Axilla Tenderness Swelling Lumps Rash

40. Objective Data Examination Privacy Comfort Anxiety

41. Retraction

43. Inspect & Palpate Axillae

44. Palpate Breasts

45. Wheel Pattern

46. Concentric Circles

47. Palpate Nipple

48. Fibocystic CancerFibroadenoma