{"id":1197,"date":"2022-11-05T14:18:04","date_gmt":"2022-11-05T18:18:04","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/inspection-and-auscultation-of-abdominal-vasculature\/"},"modified":"2024-05-03T15:46:25","modified_gmt":"2024-05-03T19:46:25","slug":"inspection-and-auscultation-of-abdominal-vasculature","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/inspection-and-auscultation-of-abdominal-vasculature\/","title":{"raw":"Inspection and Auscultation of Abdominal Vasculature","rendered":"Inspection and Auscultation of Abdominal Vasculature"},"content":{"raw":"<span style=\"color: #000000\">Inspection and auscultation of abdominal vasculature is best performed with the client in a supine position with their head on a pillow. You will be assessing the area over the abdominal aorta, renal arteries, iliac arteries, and femoral arteries (<strong>Figure 10<\/strong>). Draping is important because you will need to expose the abdomen and groin area.<\/span>\r\n<div class=\"docos-anchoreddocoview-content docos-docoview-replycontainer\">\r\n<div class=\"docos-docoview-rootreply\">\r\n<div class=\"docos-anchoredreplyview docos-replyview-first docos-replyview-comment badging-enabled-doco\">\r\n<div class=\"docos-collapsible-replyview\">\r\n<div class=\"docos-replyview-static\">\r\n<div class=\"docos-replyview-body docos-anchoredreplyview-body \" dir=\"ltr\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature.png\" alt=\"An abdomen with an arrow to the auscultory site of the aorta, renal arteries, iliac arteries, and femoral arteries.\" width=\"941\" height=\"656\" class=\"alignnone wp-image-1196 size-full\" \/><\/div>\r\n<div dir=\"ltr\">\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 10<\/strong>: Abdominal vasculature.\u00a0<\/span><span style=\"color: #000000\"><\/span><span style=\"color: #000000\">(Attribution: Adapted photo by\u00a0<\/span><a href=\"https:\/\/unsplash.com\/@sharonmccutcheon?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\" target=\"_blank\" rel=\"noopener\">Alexander Grey<\/a>\u00a0<span style=\"color: #000000\">on<\/span>\u00a0<a href=\"https:\/\/unsplash.com\/s\/photos\/abdomen-incision?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\" target=\"_blank\" rel=\"noopener\">Unsplash<\/a><span style=\"color: #000000\">, CC BY-NC 4.0)<\/span><\/p>\r\n\r\n<\/div>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Steps for assessing the <strong>abdominal vasculature<\/strong> include:<\/span><\/p>\r\n\r\n<ol>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Observe for pulsations <\/strong>over the areas of the abdominal vasculature. Use [pb_glossary id=\"1364\"]tangential lighting[\/pb_glossary] with a penlight; this will help highlight any small imperfections\/shadows, which accentuate visible pulsations.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, no pulsations are present. Pulsations may be present with a client who has a thin abdominal wall, but these are never considered normal in a client who has increased adipose tissue.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the location of any pulsations.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Auscultate<\/strong> over the abdominal vasculature (see <strong>Figure 10<\/strong>\u00a0and <strong>Video 4<\/strong>) using the bell of a cleansed stethoscope. Use slightly firmer pressure than when you use the diaphragm over the lungs or intestines. Listen for vascular sounds related to the flow of the blood through the arteries. Placing your stethoscope in each location for about 2-3 seconds is usually sufficient.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, you won\u2019t hear any vascular sounds because unobstructed blood flow through an artery is silent.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the location of any vascular sounds. Partial obstruction of an artery creates turbulent blood flow, leading to vascular sounds such as a bruit: blowing\/swooshing noises. Atherosclerosis can cause stenosis (narrowing of the vessel), leading to a bruit. If you hear a bruit, notify the physician or nurse practitioner while you keep the client still and continue to monitor them. Do not palpate the abdomen if a bruit is present, as this finding suggests that blood flow is already compromised.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the <strong>findings<\/strong>:<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cNo pulsations observed or bruits heard over the abdominal aortic artery and the renal, iliac, and femoral arteries.\u201d<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cPulsation observed over aortic artery with a bruit noted.\u201d<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n[embed]https:\/\/youtu.be\/njm5zgL9BTw[\/embed]\r\n\r\n<span style=\"color: #000000\"><strong>Video 4<\/strong>: Auscultation of the abdominal vasculature [1:27]<\/span>\r\n\r\n&nbsp;\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Priorities of Care<\/strong><\/span><\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\n<span style=\"color: #000000\">If you hear a bruit, do not palpate the area. Ask if the client has experienced any recent pain in their chest, back, abdomen, or groin, and if they have ever been diagnosed with an [pb_glossary id=\"1362\"]aneurysm[\/pb_glossary]. You should also complete a primary survey and measure blood pressure in both arms. Notify the physician and nurse practitioner of the findings. Until an aneurysm is ruled out or assessed, it is best to keep the client in bed, at rest, and under continuous monitoring.<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<h2><span style=\"color: #000000\"><strong>Activity: Check Your Understanding<\/strong><\/span><\/h2>\r\n<span style=\"color: #000000\">[h5p id=\"94\"]<\/span>\r\n\r\n<span>(Attribution: Activity Photo by <\/span><a href=\"https:\/\/unsplash.com\/@sharonmccutcheon?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Alexander Grey<\/a><span> on <\/span><a href=\"https:\/\/unsplash.com\/s\/photos\/abdomen-incision?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Unsplash<\/a>)\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<\/div>","rendered":"<p><span style=\"color: #000000\">Inspection and auscultation of abdominal vasculature is best performed with the client in a supine position with their head on a pillow. You will be assessing the area over the abdominal aorta, renal arteries, iliac arteries, and femoral arteries (<strong>Figure 10<\/strong>). Draping is important because you will need to expose the abdomen and groin area.<\/span><\/p>\n<div class=\"docos-anchoreddocoview-content docos-docoview-replycontainer\">\n<div class=\"docos-docoview-rootreply\">\n<div class=\"docos-anchoredreplyview docos-replyview-first docos-replyview-comment badging-enabled-doco\">\n<div class=\"docos-collapsible-replyview\">\n<div class=\"docos-replyview-static\">\n<div class=\"docos-replyview-body docos-anchoredreplyview-body\" dir=\"ltr\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature.png\" alt=\"An abdomen with an arrow to the auscultory site of the aorta, renal arteries, iliac arteries, and femoral arteries.\" width=\"941\" height=\"656\" class=\"alignnone wp-image-1196 size-full\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature.png 941w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature-300x209.png 300w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature-768x535.png 768w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature-65x45.png 65w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature-225x157.png 225w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2022\/11\/Abdominal-Vasculature-350x244.png 350w\" sizes=\"auto, (max-width: 941px) 100vw, 941px\" \/><\/div>\n<div dir=\"ltr\">\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 10<\/strong>: Abdominal vasculature.\u00a0<\/span><span style=\"color: #000000\"><\/span><span style=\"color: #000000\">(Attribution: Adapted photo by\u00a0<\/span><a href=\"https:\/\/unsplash.com\/@sharonmccutcheon?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\" target=\"_blank\" rel=\"noopener\">Alexander Grey<\/a>\u00a0<span style=\"color: #000000\">on<\/span>\u00a0<a href=\"https:\/\/unsplash.com\/s\/photos\/abdomen-incision?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\" target=\"_blank\" rel=\"noopener\">Unsplash<\/a><span style=\"color: #000000\">, CC BY-NC 4.0)<\/span><\/p>\n<\/div>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Steps for assessing the <strong>abdominal vasculature<\/strong> include:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Observe for pulsations <\/strong>over the areas of the abdominal vasculature. Use <button class=\"glossary-term\" aria-describedby=\"1197-1364\">tangential lighting<\/button> with a penlight; this will help highlight any small imperfections\/shadows, which accentuate visible pulsations.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, no pulsations are present. Pulsations may be present with a client who has a thin abdominal wall, but these are never considered normal in a client who has increased adipose tissue.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the location of any pulsations.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Auscultate<\/strong> over the abdominal vasculature (see <strong>Figure 10<\/strong>\u00a0and <strong>Video 4<\/strong>) using the bell of a cleansed stethoscope. Use slightly firmer pressure than when you use the diaphragm over the lungs or intestines. Listen for vascular sounds related to the flow of the blood through the arteries. Placing your stethoscope in each location for about 2-3 seconds is usually sufficient.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normally, you won\u2019t hear any vascular sounds because unobstructed blood flow through an artery is silent.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the location of any vascular sounds. Partial obstruction of an artery creates turbulent blood flow, leading to vascular sounds such as a bruit: blowing\/swooshing noises. Atherosclerosis can cause stenosis (narrowing of the vessel), leading to a bruit. If you hear a bruit, notify the physician or nurse practitioner while you keep the client still and continue to monitor them. Do not palpate the abdomen if a bruit is present, as this finding suggests that blood flow is already compromised.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Note the <strong>findings<\/strong>:<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cNo pulsations observed or bruits heard over the abdominal aortic artery and the renal, iliac, and femoral arteries.\u201d<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cPulsation observed over aortic artery with a bruit noted.\u201d<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Inspection and Auscultation of Abdominal Vasculature - Peripheral Vascular System Chapter\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/njm5zgL9BTw?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><span style=\"color: #000000\"><strong>Video 4<\/strong>: Auscultation of the abdominal vasculature [1:27]<\/span><\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Priorities of Care<\/strong><\/span><\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p><span style=\"color: #000000\">If you hear a bruit, do not palpate the area. Ask if the client has experienced any recent pain in their chest, back, abdomen, or groin, and if they have ever been diagnosed with an <button class=\"glossary-term\" aria-describedby=\"1197-1362\">aneurysm<\/button>. You should also complete a primary survey and measure blood pressure in both arms. Notify the physician and nurse practitioner of the findings. Until an aneurysm is ruled out or assessed, it is best to keep the client in bed, at rest, and under continuous monitoring.<\/span><\/p>\n<\/div>\n<\/div>\n<h2><span style=\"color: #000000\"><strong>Activity: Check Your Understanding<\/strong><\/span><\/h2>\n<p><span style=\"color: #000000\"><\/p>\n<div id=\"h5p-94\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-94\" class=\"h5p-iframe\" data-content-id=\"94\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"H5P\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/p>\n<p><span>(Attribution: Activity Photo by <\/span><a href=\"https:\/\/unsplash.com\/@sharonmccutcheon?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Alexander Grey<\/a><span> on <\/span><a href=\"https:\/\/unsplash.com\/s\/photos\/abdomen-incision?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Unsplash<\/a>)<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"glossary\"><div class=\"glossary__tooltip\" id=\"1197-1364\" hidden><p>refers to a light (penlight) directed from the side at a low angle across the body.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"1197-1362\" hidden><p>is an enlargement or ballooning of the vessel. Aneurysms can rupture, which is a life-threatening situation due to bleeding.<\/p>\n<\/div><\/div>","protected":false},"author":34,"menu_order":6,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[],"contributor":[85],"license":[56],"class_list":["post-1197","chapter","type-chapter","status-publish","hentry","contributor-january-2023","license-cc-by-nc"],"part":1171,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1197","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":4,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1197\/revisions"}],"predecessor-version":[{"id":1917,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1197\/revisions\/1917"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/1171"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/1197\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=1197"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=1197"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=1197"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=1197"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}