Abdominal Examination Flashcards
What palm signs are you looking for in an abdominal examination?
Pallor,
Palmar erythema,
Dupuytren’s contracture
What can palmar erythema be a sign of in an abdominal examination?
Chronic liver disease (sometimes present in pregnancy)
What nail signs might be present in an abdominal examination and what could these indicate?
Koilonychia –> iron deficiency anaemia,
Leukonychia –> hypoalbuminaemia (due to end-stage liver disease),
Finger clubbing –> (IBD, coeliac, liver cirrhosis, lymphoma of GI tract)
What can asterixis be a sign of in an abdominal examination?
- Hepatic encephalopathy (due to accumulation of ammonia in blood)
- Uraemia* (due to renal failure)
* raised urea
What arm signs may be present in an abdominal examination and what could these indicate?
- Bruising (suggests clotting abnormalities)
- Excoriations (to relieve pruritus caused by Cholestasis)
- needle tract marks (relavent to hepatitis)
What axillae signs may be present in an abdominal examination and what could these indicate?
Acanthosis nigricans* –> insulin resistance, benign, GI malignancy
Hair loss –> iron deficiency anaemia, malnutrition
*thickening + darkening
What eye signs are you looking for in an abdominal examination and what could these indicate?
Conjunctival pallor - anaemia Jaundice Corneal arcus - hypercholesterolaemia Xanthelasma - hypercholesterolaemia Kayser-Fleischer rings - copper deposition caused by Wilson's disease Uveitis - associated with IBD
What mouth signs are you looking for in an abdominal examination and what could these indicate?
Angular stomatitis - iron deficiency
Glossitis* - B12/iron/folate deficiency
Oral candidiasis - immunosuppression
Apthous ulceration - iron/b12/folate deficiency and Crohn’s
Hyperpigmented macules - Peutz-Jeghers syndrome
*smooth red enlargement of tongue
Where is Virchow’s lymph node and what does its presence indicate?
Left supraclavicular fossa
Can be one of the first clinical signs of metastatic intrabdominal malignancy (most commonly gastric cancer).
The right supraclavicular lymph node receives lymphatic drainage from the thorax and therefore lymphadenopathy in this region can be associated with metastatic oesophageal cancer (as well as malignancy from other thoracic viscera)
What chest signs are you looking for in abdominal examination and what can these indicate?
Spider naevi –> liver cirrhosis, but normal sign in pregnancy and women on combined oral contraceptive pill
Gynaecomastia –> increased levels of circulating oestrogen due to liver cirrhosis. Drugs like digoxin and spironolactone
Hair loss –> increased levels of circulating oestrogen/general malnourishment
What abdominal inspection signs are you looking for?
Scars, abdominal distension, striae, hernias, Cullen’s and Grey-Turners sign
What are the causes of abdominal distension?
6Fs
Foetus, fluid, flatus, fat, faeces, fulminant mass
What must you do before palpating the abdomen?
Ask the patient if they’re in pain and where
What individual organs should be palpated in abdominal examination, following deep palpation of the 9 abdominal areas?
Liver, spleen, gallbladder, kidneys, aorta, bladder
What individual organs should be percussed in abdo examination?
Liver, bladder, spleen
