Home

Is scaphoid abdomen normal

Scaphoid abdomen-Definition & Causes - TRENDY DAMSEL

Scaphoid abdomen Pictures, Definition, Symptoms, Causes

What causes a scaphoid abdomen? - Quor

  1. al wall hernias
  2. al contour (profile line from the rib margin to the pubic bone) while standing at the client's side when the client is supine. Ask the client to take a deep breath and to hold it
  3. Normally, the passage of air into the gastrointestinal tract after birth distends the scaphoid abdomen. In severe neuromuscular disease or central nervous system depression, air is not swallowed, hence the abdomen also remains scaphoid. Figure 1.71
  4. A scaphoid fracture is a break in one of the small bones of the wrist. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include pain and tenderness below the base of the thumb in an area known as the anatomic snuffbox

Normal shape of abdomen is scaphoid in supine position, moves freely with respiration in vertical direction The scaphoid bone (also known as the hand navicular) is shaped like a boat, and is one of the largest carpal bones. It is the most lateral and proximal carpal, interposed between the radius and the trapezium, at the base of the thumb Picture your patient's abdomen in four quadrants. Standing at his right side, look at the abdomen from the side and from above, from the xiphoid process to the symphysis pubis, to determine whether it's flat, scaphoid, rounded, or protuberant. If it's protuberant, ask whether this is normal for him

Scaphoid abdomen. Normal contour of abdomen. Flat abdomen. Normal contour of abdomen. Rounded abdomen. Normal contour of abdomen. Distended abdomen. Abnormal state of inflation in the abdomen. Protuberant abdomen. Abdomen is thrusting forwarding a more solid fashion. Caput medusa Normal fullness or scaphoid or flat abdomen (because it is an incomplete obstruction and no gas accumulation) Distension may commence when there is complete bowel obstruction. Visible peristalsis Tender abdomen The intussuscepted bowel can often be palpated as a tubular mass across the upper abdomen when the child relaxes between episodes of scaphoid abdomen Physical exam A hollowed anterior abdominal wall classically seen on physical exam of neonates with diaphragmatic hernia, especially through the pleuorperitoneal hiatus or foramen of Bochdalek at the periphery of the diaphragm near the attachments of the 10 th and 11 th ribs; SA also occurs in jejunal atresia and in infants with pyloric stenosis; SAs in adults may be linked to.

What is the normal shape of abdomen

Auscultation Normal Abnormal Bowel Sounds-High-pitched, gurgling, cascading sounds occurring w/ irregularity around 5-30 times a minutes-Borborygmus: stomach growling is considered hyperactive yet common -Silence: must listen for 5 minutes to confirm -Hypoactive: occurring in post-op pts or w/ inflammation of the peritoneum-Hyperactive: loud, high-pitched, rushing, tinkling sounds that. Because the abdominal contents are displaced into the chest, the abdomen often is scaphoid. Cases have been reported in which the infants remain relatively asymptomatic in the early hours and days of life In the normal newborn, the liver should be palpable. You can locate it approximately one finger below the ribs on the right-hand side of the abdomen (right upper quadrant). The spleen may be palpable just above the stomach in the left hand upper quadrant of the abdomen. The bladder however, should not be palpable above the pubis (Kain & Mannix. 638x479 - Occurring only in boys, pbs causes a baby to have an enlarged abdomen because the normal abdominal wall muscles are missing or very weak. Original Resolution: 638x479 Congenital Diaphragmatic Hernia By Dr Varsha Atul Shah Scaphoid abdomen is a condition in which the anterior wall of the abdomen is sunken and shows a hepatitis is a. Scaphoid - seen in school-aged children and wasting diseases. c. Round - pot belly; normal in infants and toddlers You must auscultate before you percuss or palpate abdomen because these maneuvers may alter the frequency of bowel sounds. Enhanced peristaltic sounds may mask other abnormal abdominal sounds such as bruits and friction rubs.

The Newborn Examination: Part II

showing scaphoid abdomen

If it is a stomach buldge, seen on the right side of upper abdomen then it is normal and there is nothing to worry. In scaphoid (thin) abdomen there are possibilities of observing a dilated stomach after meals in the right side of the upper abdomen. The anatomy of the stomach makes it puffier on the right side than the left Stomach contour scaphoid, flat, rounded, protuberant? Noted pulsations at the aorta (noted in thin patients): The aortic pulsation can be noted above the umbilicus. Characteristics of the navel (invert or everted) Masses (check for hernia after auscultation), PEG tube? Auscultate with the diaphragm for bowel sounds Organs in the abdomen (such as intestines, stomach, and liver) can move through the hole in the diaphragm and upwards into a baby's chest. When an organ pushes through the hole, it is called a hernia. A diaphragmatic hernia can prevent the baby's lungs from developing completely, causing breathing difficulties for the baby at birth The remainder of the normal abdomen is, for the most part, filled with the small and large intestines. Try percussing each of the four quadrants to get a sense of the normal variations in sound that are produced. These will be variably tympanitic, dull or some combination of the above, depending on whether the underlying intestines are gas or. To assess whether an image is purely lateral, consider the relationship between the capitate, pisiform and the scaphoid bones. The palmar cortex of the pisiform should be located centrally between the palmar cortex of the capitate and the scaphoid (fig. 4). Note: additional anatomy is discussed in the Normal Anatomy section. Figure 4

Patients who have excessive abdominal fat pose a challenge for abdominal US examination because the layer of adipose tissue between the probe and the internal organs can make it difficult for physicians to locate the internal organs. Doctors will have to apply a little extra force in order to try to get the probe as close to the internal organs. Stomach Cancer Stages. After someone is diagnosed with stomach cancer (gastric cancer), doctors will do exams and tests to help determine if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes the extent of the cancer in the body. It helps determine how serious the cancer is and how best to treat it The scaphoid tubercle can therefore be easily and accurately palpated on the palmar aspect of the radially deviated wrist. Besides, where is the scaphoid bone located? The scaphoid is a carpal bone in the wrist. It sits on the radial or lateral side of the wrist near the thumb. It is the largest bone in the wrist's proximal row The scaphoid bone is one of the carpal bones in your hand around the area of your wrist. It is the most common carpal bone to break (fracture). A scaphoid fracture is usually caused by a fall on to an outstretched hand. Symptoms can include pain and swelling around the wrist. Diagnosis of a scaphoid fracture can sometimes be difficult, as not.

How is a scaphoid fracture diagnosed? Your healthcare provider will examine your hand and wrist, and check for tenderness. He or she will ask about the pain, and how you hurt your wrist. You may need any of the following: X-rays are used to check for a broken scaphoid bone. An MRI or CT scan are used to check for a broken bone or other problems. ABDOMEN Normal Findings: In infants, the abdomen is prominent in supine position. Abnormal Findings: A scaphoid (boat-shaped) abdomen may result from malnutrition or dehydration. Distended abdomen may indicate pyloric stenosis. Inspect the shape of the abdomen 38. Distended Abdomen Scaphoid (boat-shaped) 39 Wrist bones - Normal X-ray (Lateral) Hover on/off image to show/hide findings. Tap on/off image to show/hide findings. Click image to align with top of page. Wrist bones - Normal X-ray (Lateral) Multiple wrist bones overlap; The scaphoid (red) is difficult to see clearly on this vie The normal dorsal ridge appears as a localized irregularity of the radial aspect of its cortex and should not be confused as a cortical buckling or incomplete fracture. The scaphoid view is not required in infants and very young children because scaphoid fractures are rare in this age group and the scaphoid does not ossify until 6 years of age

A Comprehensive Newborn Exam: Part II

findings regarding CVA tenderness under abdomen - see example * LUNGS Percussion and Palpation of Lung Fields-nl resonant percussion Auscultation-clear, nl vesicular breath sounds (An accepted abbreviation for normal lung Percussion & Auscultation is Clear to A&P) HEART Neck Veins- JVD at 45° Carotid Arteries Malrotation often presents with signs of upper GI obstruction, including bilious vomiting and progressive dehydration. Obstruction can be caused by Ladd's bands compressing the duodenum or from volvulus. Findings on physical examination may be normal early in the course or may reveal a scaphoid abdomen as a result of the proximal obstruction Congential diaphragmatic hernia may present with an abdomen that appears flat relative to the chest (scaphoid abdomen), but in that case severe respiratory distress would be expected. photo by Janelle Aby, M The nurse is describing a scaphoid abdomen. To the horizontal plane, a scaphoid contour of the abdomen depicts a _____ profile. a. Flat b. Convex c. Bulging d. Concave. ANS: D. 9 9. While examining a patient, the nurse observes abdominal pulsations between the xiphoid process and umbilicus. Normal abdominal aortic pulsations. d. Increased.

Generalized abdominal distention may be seen in gas retention or obesity. Lower abdominal distention is seen in bladder distention, pregnancy, or ovarian mass. General distention and an everted umbilicus are seen with ascites and/or tumors. A scaphoid (sunken) abdomen is seen in malnutrition or when fat is replaced with muscle A normal abdomen extends from the lower rib cage above ( costal margins/ hypochondrion) to the pubic margins below, staying scaphoid or flat or protuberant as the case may be as it extends between both ends . The more obese the individual, the greater the sweep towards protuberant or in the reverse, the scaphoid The abdomen should be round and symmetric. A scaphoid abdomen may indicate a diaphragmatic hernia, allowing the intestine to migrate through it to the chest cavity in utero; pulmonary hypoplasia and postnatal respiratory distress may result. An asymmetric abdomen suggests an abdominal mass Wrist ultrasound education showing how to, scanning protocol, normal anatomy, anatomic variants, tendon, ligament, carpal tunnel, nerves GooGhywoiu9839t543j0s7543uw1. Please add analytics5@thewebshowroom.com.au to GA account UA-17294186-1 with Manage Users and Edit permissions - date Aug 10, 2017 Manage a scaphoid fracture and help your wrist heal: Apply ice on your wrist for 15 to 20 minutes every hour, or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it. Ice helps prevent tissue damage, and decreases pain and swelling. Elevate your wrist above the level of your heart as often.

Abdomen exam

What are normal sounds when Percussing the abdomen

Of the 110 wrists with normal initial x-rays, 69 were immobilized and 52 of those had a follow-up x-ray (47 normal, 1 scaphoid fracture, 1 nonscaphoid fracture, and 3 equivocal evidence of a scaphoid fracture). The positive predictive value was found to be 2.1% to 12.5% Acute Abdomen Dr.Teresa Galdona PA-C . We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads For example, the presence of a scaphoid abdomen in a neonate with respiratory distress may indicate diaphragmatic hernia, but not in an older child. Also in the newborn, the appearance or persistence of the umbilical stump may generate clues to a source of fever, to an underlying immunological disorder, or to liver or pancreatic disease. [ 13 Normal- flat to rounded) - Symmetry (note any localized bulging, masses) - Umbilicus(midline and inverted, discoloration, inflammation, hernia) - Skin (color, striae, moles, scars, veins. turgor) - Pulsation or movement (aortic) - Hair Distribution - Scaphoid abdomen, protuberant. abdomen and abdominal distension are abnormal. - Hernia. However, the wrist fractures associated with the scaphoid bone (carpal bone at the base of the thumb) are more alarming (18). According to the study published in the Polish Journal of Radiology , the PA position during the wrist CT scan is the view recommended in the interpretation of the distal radioulnar and intercarpal articulations (19)

Inspection, Auscultation, Palpation, and Percussion of the

NURS 2300 Final Exam Study Guide Fall, 2019 Week 9: Abdomen Understand the 4 quadrants plus epigastric, umbilical and suprapubic areas and where the structures/organs lie: Adrenal Glands: sit on top of kidneys Aorta: midline Appendix: right lower Ascending colon: right lower & upper Bladder: suprapubic Cecum: right lower Descending colon: left upper & lower Duodenum: right upper. Add the necessary commas to make complete sentence, Abdomen showed extensive scarring scaphoid appearance no masses or organomegaly no tenderness and normal bowel sounds. Grammar. Add commas to make sentence complete. She is status post cholecystectomy, appendectomy, and bilateral hip prostheses. Abdomen was soft gassy and nontender. englis abdomen [ab´dah-men, ab-do´men] the anterior portion of the body between the thorax and the pelvis; it contains the abdominal cavity, which is separated from the chest area by the diaphragm. The cavity, which is lined with a membrane known as the peritoneum, contains the stomach, large and small intestines, liver, spleen, pancreas, kidneys. School of Nursing. 5th Floor Fisher Hall 600 Forbes Avenue Pittsburgh, PA 15282 Email: nursing@duq.edu Phone: 412.396.6550 Fax: 412.396.634

What does scaphoid abdomen indicate? - AskingLot

Abdominal examination: Scaphoid, soft and mildly tender in the right lower quadrant. Musculoskeletal examination: Unremarkable. Skin examination: Normal. The most likely diagnosis for this child's short stature is? Celiac. Constitutional Delay. Familial Short Stature. Inflammatory Bowel Disease Fracture in proximal pole of scaphoid + tear of scapholunate ligament. After an x-ray, MRI and CT scan, the hand specialist I went to see gave me the diagnosis in the title, and told me that I'll have to have a surgery. That being said, even with the surgery I'll have to wear a cast afterwards for at least 2 months, and there's a likely chance. 14. During an abdominal assessment the nurse would consider which of these findings as normal? a. Presence of a bruit in the femoral area b. Tympanic percussion notes in the umbilical region c. Palpable spleen between the ninth and eleventh ribs in the left midaxillary line d. Dull percussion note in the left upper. - Scaphoid - Recognize abdominal landmarks: - Costal margin - Midline - Umbilicus - Normal frequency is _____ sounds per minute - Have the patient lift their head to differentiate intra-abdominal from extra-abdominal masses - Palpate specific abdominal organs: - Liver - Splee The abdomen is flat or sunken (scaphoid), rather than rounded as in the better-nourished infant. At birth, the umbilical cord is commonly thin, in contrast to the normal cords, which are rotund, gray, glistening, and moist. Because all cords wither progressively after birth, their condition after 24 hours of age is of little diagnostic.

Abdomen: Scaphoid without scars. No abnormal tympany. Normal bowel sounds, no bruits. Superfiecial & deep palpation without organomegaly or masses; no direct or rebound tenderness, rigidity, or guarding. Liver edge soft (or: not palpable), liver span 10 cm. Spleen normal size (or: not palpable), kidneys not palpable. Extremities Percussion Technique (cont) •Liver span (6-12 cm): Start in chest, below nipple (mid-clavicular line) & move down -tone changes from resonant (lung) to dull (liver) to resonant (intestines) •Spleen -small, located in hollow of ribs -percussion over last intercostal space, anterior axillary line should normally be resonant - dullness suggests splenomegal Right upper abdomen: Liver tumor, hepatitis. Left upper abdomen: Splenomegaly, gastric tumor. Upper half of the abdomen: Pancreatic cyst or tumor or acute gastric dilatation. Lower half of the abdomen: Pregnancy, ovarian tumor, uterine fibroids, or bladder distention. Scaphoid abdomen: Malnutrition Assess width of aorta pulsations. Normal is 2.5cm in width, not including abdominal wall thickness. Prominent pulsations with lateral expansion suggest an abdominal aortic aneurysm. Evaluation of Acute Abdomen/Appendicitis Pain Visceral (originating from the intra-abdominal organs) Usually dull qualit

ABDOMEN: Soft, scaphoid and reproducibly tender in the right lower abdomen with voluntary guarding. No peritoneal signs. ABDOMINAL EXAM: Hyperactive bowel sounds, nontender. ABDOMEN: Soft, morbidly obese. Diffusely tender. There is no palpable pulsatile mass; however, the patient's morbid obesity would likely obscure this Then the physician applies pressure to the palm side of the scaphoid as the wrist is bent toward the thumb. Relief of pressure will allow the scaphoid to slip back into place with a clunk. However, this test may be positive in many normal wrists, so it must be interpreted with caution and compared to the other side Abdominal hernias typically include some of the membranous sac that encircles the abdominal organs (the peritoneum). They may also include fatty tissue and portions of the intestine. They may or may not be painful, and they are typically seen as a bulge in the abdomen, groin, labia or scrotum that increases in size over time Gait: Gait normal. XRAY right hand: FINDINGS: No soft tissue mass is seen. No definite tumor like lytic or blastic changes are seen. IMPRESSION: There is a likely nondisplaced distal scaphoid fracture. Consider follow-up 3 view wrist x-ray and navicular view in 7-10 day The umbilicus is a rich source of signs. Psoriatic plaques have a predilection for the navel. Most common is the everted umbilicus (Fig. 1A,B), which occurs when raised intra-abdominal pressure and massive ascites push against an umbilical hernia. The term portal hypertension was coined in 1906 by Gilbert and Villaret, who punctured the abdomen in patients with cirrhotic ascites and found.

The anatomical snuff box or snuffbox or foveola radialis is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates from the use of this surface for placing and then sniffing powdered tobacco, or snuff.It is sometimes referred to by its French name tabatièr Vague Symptoms. A 42-year-old obese woman presented to the ED with vague abdominal pain, belching, nausea, vomiting, and dizziness, along with shortness of breath and upper back pain for the. (locate scaphoid at a point 2 cm [3/4 inch] distal and medial to radial styloid process.) Minimum SID of 40 inches (100cm) Collimation: Collimate on four sides to carpal region. Note: Stecher* indicate that elevation if the hands of 20degrees rather than angling of the CR places the scaphoid parallel to IR There has been a move towards earlier more advanced methods of imaging. A great study from Ballarat discusses the use of day 1 CT in patients with suspected scaphoid fractures who have a normal xray. They argue the benefits of not needing to early immobilise these patients is worth the healthcare cost. Sensitivity 72-100% and Spec 80-100%

HA II Exam 1 - Health Assesment with Domagala at

Abdominal asymmetry CLINIPEDI

1. Widened and narrowed joints, but there is normal parallelism , so there is no dislocation. 2. Scapholunate dissociation with widening of the SL joint and foreshortening of the scaphoid due to palmar tilt. 3. Arthrosis of the Radioscaphoid and Capitolunate joint due to the abnormal movements of scaphoid and lunate. 4 Report Templates. CT scan of the abdomen has been done with administration of oral and intravenous contrast media. Liver shows normal size, shape and attenuation. No mass lesion or calcification in the hepatic parenchyma. The porta hepatis is normal. No IHBR or CBD dilatation. Gall bladder reveals normal lumen and walls with normal size and shape The scaphoid is intact and in the normal position. The PA image shows a discrete fracture line in the radial styloid process (to a lesser degree visible on the fist image also). There is no dislocation. Diagnosis? Intra-articular distal radial fracture (chauffeur fracture) Abdominal examination reveals a soft, scaphoid, nondistended abdomen, with no tenderness to palpation and normal bowel sounds. Musculoskeletal survey reveals normal range of motion, and skin examination reveals skin that is warm, relatively well-perfused, and without any lesions

PPT - Abdominal Examination PowerPoint Presentation, free

Scaphoid injury. 30 Female White 5ft3 60kgs. June 2019 I snapped my left scaphoid bone and fractured the tip of the left radial bone. I was in a cast inc thumb for 8 weeks. It was removed when a CT scan confirmed I had healed well. About a year ago, Nov 2019 I started to get pains in my wrist - I put it down to cold weather etc it finally got. The scaphoid is the most frequently fractured carpal bone, accounting for 71% of all carpal bone fractures. Scaphoid fractures often occur in young and middle-aged adults, typically those aged 15-60 years, after a fall on an outstretched arm that results in acute dorsal flexion of the wrist. About 5-12% of scaphoid fractures are associated with other fractures, and approximately 1% of scaphoid. c. scaphoid Normal bowel sounds are described as audible. Alteration sounds are described as absent. Extremely soft and infrequent. · During expiration, the abdominal wall relaxes, facilitating deep palpation. Maintain your hand position, and ask the client inhale deeply

If an individual receives one normal gene and one gene for the disease, the person will be a carrier for the disease, but usually will not show symptoms. The risk of transmitting the disease to the children of a couple, both of whom are carriers for a recessive disorder, is 25 percent. and a hollow or boat shaped abdomen (scaphoid abdomen) X-ray films of the clavicles, elbows, and feet were normal. No renal dysplasia could be found by ultrasonography of the abdomen. Discussion In this patient the carpal scaphoid hypoplasia is associated with hypoplastic or absent thenar muscles and underdevelopment of the thumb-ray bones Scaphoid abdomen can be seen in cachectic patients, whereas global abdominal protuberance can result from gas, fluid, or fat. Check whether the abdomen looks symmetric or not. Asymmetry is a warning sign and can suggest masses or organomegaly

Tri-scaphoid Osteoarthritis. What is it? The triscaphoid joint is located within the wrist joint, and involves the scaphoid, trapezium and trapezoid bones. The joint is important because it provides a strong and stable link between the two rows of bones in the wrist, and transmits force from the thumb across the wrist joint. Arthritis in this. A scaphoid or boat-like abdomen suggests weight loss, with possible malnutrition. Localized distention usually indicates obstruction or enlargement of an individual organ or structure • Normal Development - Cranial-caudal folding basically establishes the precursors of all the structures and cavities these structures will invest in the normal thoracic cavity . Embryology scaphoid abdomen with a lack of bowel sounds, and cyanosis relieved with oxyge

2016 GI AssessmentAriyati's blog " Have You Worship(prayer)? ": PENGKAJIAN

7 Normal Findings a Abdomen is flat rounded or scaphoid

MRI of the wrist: normal anatomy. The radiocarpal joint, more commonly known as the wrist, is the articulation between the distal forearm and the hand. It is formed by the apposition of the radius and three proximal carpal bones: scaphoid, lunate and triquetrum. The radiocarpal joint is reinforced by several ligaments and provides the passage. Evaluate for occult scaphoid fracture. Left wrist pain. Diffuse T2 and T1 signal abnormality involving the midportion of the scaphoid bone compatible with a hairline fracture midbody of the scaphoid. Cortical margins appear intact without evidence for 2-part injury. Normal overall morphology and outline of the scaphoid Examination of the abdomen involves the usual four skills, except that the order is significantly changed. Inspection is followed by auscultation, percussion, and then palpation, which may distort the normal abdominal sounds. The medical practitioner in charge must have knowledge of the anatomic placement of the abdominal organs in order to differentiate normal, expected findings from abnormal.

abdominal assessment

Health Assessment - Abdomen Flashcards Quizle

Click for pdf: Respiratory Distress General Presentation Respiratory distress is a clinical condition characterized by the presence of one or more signs of increased work of breathing including: tachypnea, nasal flaring, grunting, and chest wall retractions. It is vital to recognize these signs early and alleviate respiratory distress in the newborn because the patient can [ A health care professional will take a sample of your breath by having you breathe into a bag at your doctor's office or at a lab. He or she then sends your breath sample to a lab for testing. If your breath sample has higher levels of carbon dioxide than normal, you have H. pylori in your stomach or small intestine. Stool test

Inspection of abdome

Assess the abdomen: scaphoid abdomen in diaphgragmatic hernia Consider neurological disorders: observe for apnea and periodic breathing, which may be related to immaturity of the nervous system. Seizures can cause cyanosis if the infant fails to breathe during the episodes CM is associated with abdominal wall defects like prune belly syndrome and other urogenital tract anomalies in nearly 85% of the cases. 2 Scaphoid variety has the absence of hypoplastic spongiosum. Plain radiograph of abdomen was and continues to be a great and useful tool and diagnostic array of neonatal intestinal obstruction. It was the only tool in the past. Is the abdomen distended/scaphoid on radiograph? c) What is the gas pattern? d) Is the gas pattern symmetric/asymmetric? normal shadow of cord, soft tissue produced by.

Abdominal: Inspection - AccessPharmac

Scaphoid nonunions with deformity are associated with abnormal wrist kinematics that may be associated with symptoms, as well as progressive radiocarpal and midcarpal arthrosis (often referred to as scaphoid nonunion advanced collapse; SNAC). 3 Surgery intends to achieve more normal wrist kinematics and to slow or arrest the development of SNAC Background: FOOSH injuries, or falls onto outstretched hands, are a common presentation to the emergency department, and can frequently result in scaphoid fractures. In fact, scaphoid fractures account for 90% of all carpal fractures and 2-7% of all fractures (Dias). The most common location for a scaphoid fracture is within the scaphoid waist The stomach, intestine, and other abdominal organs are moved from the chest cavity back to the abdominal cavity. The hole in the diaphragm is repaired. This may be accomplished either by an open operation (laparotomy) or a minimally invasive surgical approach either through the chest (thoracoscopy) or abdomen (laparoscopy) 2. The nurse learns a client has been taking more than three times the recommended amount of an over-the-counter pain (OTC) reliever on a daily basis for several months. On the basis of this finding, which of the following is the nurse most concerned about? A. Potential for alterations in pancreatic enzyme production Scaphoid: boat shaped bone and forms the radial portion of the carpal tunnel. It is important for stability and movement at the wrist and may be fractured after a fall onto a hyper-extended hand. Scaphoid fracture may be radiologically occult in the acute setting and may result in avascular necrosis Lunate: semilunar bone. Convex proximal facet for the radius. It articulates with the scaphoid.