Pulse heard over RUQ & LUQ?

  1. 0 When listening for bowel sounds, a loud pulse was heard over the RUQ & the LUQ, but is not heard in either of the lower quadrants of the abdomen. What could this be?
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  3. Visit  here_we_stand profile page

    About here_we_stand

    Joined Oct '13; Posts: 10.

    32 Comments so far...

  4. Visit  RNGriffin profile page
    4
    You tell us....where are pulses normally heard?...if you said veins, arteries, and the heart you're on the right track...
    what's in the abdomen that could be pulsating (granted your finger wasn't on the bell)?

    I noticed you are a student. I am a firm believer we all, even experienced, should be challenged to critically think what could be going on with our patients. If we're just here to give information to one another, we'll never grow as professionals.


    What do you think it is? Once you have assessed your patient or your clinical data, we'll be able to critically think collectively.
    Last edit by RNGriffin on Feb 12, '14
    Lev <3, LadyFree28, Retired APRN, and 1 other like this.
  5. Visit  TU RN profile page
    1
    It means the heart is in closer proximity to the UQs than the LQs. Think about it, the resonance of the "lub-dub" sound will be greater in the thorax and upper abdomen (with their "hollow organs") and lesser in the lower abdomen as the dense, compact intestines absorb much of the sound.
    RNGriffin likes this.
  6. Visit  RNGriffin profile page
    4
    Quote from TU RN
    It means the heart is in closer proximity to the UQs than the LQs. Think about it, the resonance of the "lub-dub" sound will be greater in the thorax and upper abdomen (with their "hollow organs") and lesser in the lower abdomen as the dense, compact intestines absorb much of the sound.
    Your explanation is a possibility( though I've never experienced this upon auscultation of the abdomen). But, there is another structure in the abdominal area that could be causing an audible pulse, as well as a pulsating sensation.
    Last edit by RNGriffin on Feb 12, '14
    Lev <3, LadyFree28, emtb2rn, and 1 other like this.
  7. Visit  Esme12 profile page
    5
    Moved for best response.

    Is this a large person or a small one? Could you palpate a pulsatile mass? What major artery might you be hearing in the abdomen?

    Think about your anatomy.
    Lev <3, LadyFree28, speasa204, and 2 others like this.
  8. Visit  emtb2rn profile page
    7
    Quote from Esme12
    Moved for best response. Is this a large person or a small one? Could you palpate a pulsatile mass? What major artery might you be hearing in the abdomen? Think about your anatomy.
    I'm thinking what you're thinking and and that kind of thinking will lead to an 18 in the ac along with a bunch of stat orders. "Hey ct, it's emtb2rn, can we reprioritize your priorities?"
    ICULINDA, Luckyyou, LadyFree28, and 4 others like this.
  9. Visit  Halcyonn profile page
    0
    Wait, what were you thinking? I thought DA. I mean, sometimes after I eat I can watch my abdomen pulsate. I always assumed it was my DA.

    Why are we rushing to ct? Should I be worried?
  10. Visit  Esme12 profile page
    0
    I"m sorry what is DA?
  11. Visit  GrnTea profile page
    6
    What's DA? District attorney? What s/he doing in/on your abdomen? Or are you pregnant and your kid is more active with your borborygmi after you eat?
    psu_213, LadyFree28, Halcyonn, and 3 others like this.
  12. Visit  JustBeachyNurse profile page
    5
    Do you mean descending/abdominal aorta? DA is not a standard or acceptable abbreviation. I'm overtired & guessing but my first thought was the same as GrnTea that what on earth did you do that the DA is sitting on your abdomen?!?! I know my sister the ( major US county) ADA can be ruthless, but she worked major crimes/homicide before her recent transfer and she'd leave the abdomen sitting to the detectives & investigators. She saves her battles for the courtroom.
    psu_213, Ads2627, Halcyonn, and 2 others like this.
  13. Visit  Halcyonn profile page
    0
    Ha! Yes, I meant descending aorta. I was purposefully vague in order to let the original poster attempt to figure it out. I didn't want to spoil the thread.
  14. Visit  RNGriffin profile page
    0
    Quote from Halcyonn
    Ha! Yes, I meant descending aorta. I was purposefully vague in order to let the original poster attempt to figure it out. I didn't want to spoil the thread.
    The Aorta is audible in the abdomen in the presence of another condition. But, please never abbreviate DA, as it is not an approved abbreviation & the nurse coming behind you would never understand what you meant by DA.
  15. Visit  Halcyonn profile page
    3
    Wow, my bad everyone. I realize that DA is not an "official" abbreviation and I would/will never use it to document. I'm sorry

    Since the original poster hasn't returned yet...

    Would an aortic aneurysm be audible in the abdomen?
    psu_213, Esme12, and GrnTea like this.


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