Abdominal Examination Flashcards
What are the first steps?
Introduction
Ask name and DOB
Consent
Ask if they are in any pain
What do you look for on general inspection?
Ascites
Scars
Pallor
Jandice
Hyperpigmentation
Oedema
Cachexia
Hernias
What equipment do you looks for on general inspection?
Stoma
Feeding tubes
ECG leads
Mobility aids
Fluids
What’s the first thing you inspect ?
Hands
What are you assessing the hands for?
Nails - Koilonychia ( spoon nails)
Leukonychia ( whitening )
Palms - Pallor, Palmar , Dupuytren’s contracture
Finger clubbing
Asterixis
What does Palmor Erythema indicate?
Chronic liver disease
What does Koilonychia indicate?
Iron deficiency anemia
What does Leukonychia indicate?
Hypoalbuminaemia
What does finger clubbing indicate ?
IBD
Coeliac
Liver cirrhosis
What does asterixis indicate?
Hepatic encephalopathy
What else do you assess the hands for?
Symmetrical temperature
Radial pulse
What does Dupuytren’s contracture indicate
Excessive alcohol consumption
Diabetes
What do you inspect the face for?
Anaemia
Jaundice
What do you inspect the mouth for?
Mouth ulcers
Angular stomatitis
Glossitis
Oral candidiasis
What do you inspect the eyes for ?
Conjunctival pallor
Jaundice
Corneal Arcus
Xanthelasma
Kayser-Fleischer rings
What does Corneal Arcus suggest?
Hypercholesterolaemia
What does Xanthelasma suggest?
Hypercholesterolaemia
What does Kayser-Fleischer rings suggest?
Abnormal copper processing of liver
What lymph nodes do you palpate?
Supraclavicular
Submandibular
Submental
Anterior and Posterior Cervical
Occipital
Virchows!!!
What is Virchow’s Node?
Left Supraclavicular lymph node
How do you inspect the abdomen ?
Ask patient to lie flat
Hands by sides
What are you inspecting the abdomen for?
Scars
Striae
Masses
Distension
Gynaecomastia
Spider Naevi
Stomas
Pulsation
Cullen’s Sign
Grey Turners Sign
What are the 9 different areas of the stomach ?
Right hyperchondrium
Epigastrium
Left hyperchondrium
Right flank
Umbilical region
Left flank
Right iliac fossa
Suprapunic region
Left iliac fossa
How do you palpate the abdomen?
Ask if patient is in any pain
Lightly palpate 9 areas
Deeply palpate 9 areas
How do you palpate liver?
Right iliac fossa
Ask them to deep breathe
How do you palpate the spleen ?
Right iliac fossa to the suprapunic region,
How do you ballot the kidneys ?
Press on Right and Left Iliac Fossa’s and feel for kidneys on sides of stomach
What else do you palpate?
Palpate the aorta
Middle around epigastric
What is Cullen’s Sign?
Bruising of umbilicus region ( late pancreatitis signs)
What is Grey-Turner’s sign?
Bruising of the flanks ( late haemorrhaging pancreatitis )
Which parts of abdomen do you percuss?
Liver
Spleen
Shifting dullness ( if relevant)
Fluid thrill ( if relevant )
What do you percuss?
Borders of the liver
Borders of the spleen
Shifting Dullness ( if Ascites is suspected )
What do you auscultate?
Bowel sounds ( lower left + right )
Aortic bruit ( middle central )
Renal arteries ( lateral to aortic )
What would you do to complete the examination
Check hernial orifices
External genitalia
Digital Rectal Examination
