Abdominal Exam

Question 1

Inspection

Answer 1

Pt supine; Expose abdomen from sternum to pubis with gown/drape to maintain modesty.

• Skin color, lesions, scars, dilated veins
• Size, contour and symmetry
• With patient’s head lifted - look for hernia

Question 2

Ascultation

Answer 2

auscultate before percussion/palpation

• Bowel sounds (all 4 quadrants, 5-10 seconds each)
• Bruits (renal and aortic)

Question 3

Percussion

Answer 3

• All four quadrants: listen for tympany, dullness

- Liver span (may use scratch test) - normal is 6-12cm

Question 4

Palpation

Answer 4

• Light palpation (all 4 quadrants)
• Deep palpation (all 4 quadrants)
• Murphy’s sign (gallbladder)
• McBurney’s point (RLQ)
• Rovsing’s sign (LLQ)
• Liver, spleen, aorta

Question 5

Assess for pain

Answer 5

• Rebound tenderness

- Costovertebral angle (CVA) tenderness