Abdominal exam

Question 1

What is involved in the initial inspection during the GI exam?

Answer 1

Well/unwell, discomfort
Obvious distension
Body habitus
Colour (jaundice, pallor)

Question 2

What is involved in inspection of the hands and arms in the GI exam?

Answer 2

Hands
-Clubbing
-Nails (leukonychia, koilonychia)
-Palmar erythema
Arms
-Metabolic flap
-Bruising, petechiae, spider naevi

Question 3

What is involved in inspection of the face in the GI exam?

Answer 3

Eyes = conjunctival pallor, jaundiced sclera
Face = palpate for enlarged parotid glands
Mouth = angular stomatitis (due to iron def, e.g GI malignancy, malabsorption), check gums and dentition
Tongue = macroglossia, glossitis, leucoplakia

Question 4

What is involved in inspection of the neck and chest during the GI exam?

Answer 4

Lymph nodes = supraclavicular
Bruising, petechiae, spider naevi
Gynaecomastia (in men)

Question 5

What is involved in inspection of the abdomen in the GI exam?

Answer 5

Look for any general or localised abdominal distension
Look for petechiae, bruising, spider naevi
Look for caput medusae (circulatory issues related to liver disease)
Look for scars suggestive of previous surgery

Question 6

What is a part of examination of the abdomen in the GI exam?

Answer 6

Adequate exposure
Inspection of the abdomen
Ask patient if there is any pain in the abdomen

Light palpation followed by deep palpation (ending where the pain is)

Liver palpation followed by percussion

Spleen palpation in supine followed by repositioning patient (45 degrees to examination table) and palpating again

Kidney balloting

Percuss the bladder for urinary retention

Check for shifting dullness due to ascites, repositioning patient to side and checking again

Auscultation for bowel sounds, aortic bruits, renal bruits