Abdominal Exam OSCE notes Flashcards
Inspection: 4 general things
color, symmetry , surface motion (peristalsis), pulsations
inspection: color
jaundice, grey turner sign, cullen sign scares, dilated veins, rashes and lesion
Grey turner sign
flank ecchymosis, secondary to hemorrhage
Cullen sign
ecchymosis around the umbilicus (periumbilical) secondary to hemorrhage
Inspection: contour/symmetry
abdominal distention
hernias, masses
inspection: surface motion
peristalsis, pulsations
Auscultation of bowel sounds: normal/abnormal
5-35 clicks or gurgles per minute
abnormal: high pitched, decreased or absent
Auscultation of bowel sounds: vascular sounds
what side of the stethoscope do you use?
abdominal aorta, iliac, renal, and femoral arteries.
listen for bruits with bell of stethoscope
Percussion of the abdomen: what sounds?
tympanic and dullness
tympanic sounds
found in the majority of the abdomen, caused by air filled viscera
dullness sounds
flat without echoes, heard over solid organs. the liver and spleen, fluid in peritoneum or feces give a dull note
percussion of liver: expected liver span
6-12 cm at the mid clavicular line
percussion of the spleen: expected spleen span
6-10 cm at the mid axillary line on the left
Palpation: general considerations
warm hands, if needed, bend patients knees to relax the abdominal muscles
examine tender areas last
palpate all four quadrants
Palpation: light palpation
Light palpation
use tips of fingers to touch skin ~1 cm
