Abdominal Exam

Question 1

what should you look for in a abdo exam?

Answer 1

general inspection
hands - temp, clubbing, palms
liver flap
radial pulse
arms + axilla
eyes + mouth
cervical + virchows node
chest - scars, spider naevi, gynaecomastia (front and back)

Question 2

what should you palpate in an abdo exam?

Answer 2

9 areas (superficial + deep)
liver - deep breath start in right iiac fossa
murphy’s - patient breath outr and then place hand below right costal margin in mid clavic line
spleen - deep breaths start in right iliac fossa and move towards left costal margin
kidneys - ballot
bladder - suprapubic region
aortic pulsation

Question 3

what should you percuss in an abdo exam?

Answer 3

liver (percuss up from RIF from resonant to dull then down from right chest to determine size)
spleen (percuss from RIF to towards left costal amrgin)
bladder (suprapubic region, should be dull)
if ascites is suspected -> shifting dullness (percuss from centre towards left flank if dull note heard keep finger in position and get patient roll onto their right wait 10 seconds + percuss -> note resonant then percuss back to umbilicus

Question 4

What shoud you auscultate in an abdo exam?

Answer 4

bowel sounds
aortic (1-2cm above umbilicus) + femoral bruits

Question 5

How do you complete an abdo exam?

Answer 5

inguinal lymph nodes
examine stools
examine hernial orifices
rectal exam with a chaperone
urine analysis
examine the external genitalia