Abdominal examination Flashcards
How do you start an abdominal examination?
- introduce self
- check name & DOB
- explain procedure
- gain consent
- positions patient & exposes
- wash hands
What should you look for on general inspection?
look for pain, discomfort, pallor, colour, muscle wasting, distention of abdomen
- any drains, vomit bowls
What should you look for on the hands?
- clubbing
- palmar erythema
- dupuytren’s contracture
- peripheral cyanosis
- spinder naevi
- leukonychia
- flapping tremor
What should you look for on the face?
- xanthelasma
- yellow sclera (jaundice)
- conjunctival pallor (anaemia)
- tlangiectasia
- stomatitis
- glossitis
- ulcers
- central cyanosis
What should you look for on the abdomen?
- Fluid/flatus/fat/foetus/faeces
- symmetry
- normal respiratory movement
- scars and striae
- distended veins
- abdominal masses
- abnormal pulsations
What are the regions of the abdomen?
- right hypochondrium
- epigastrum
- left hypochondrium
- right flank/lumbar
- umbilical region
- left flank/lumbar
- right iliac fossa
- suprapubic
- left iliac fossa
How should you palpate the abdomen?
- keep contact with abdomen
- look at the patient for pain
- assess 9 regions lightly
- reassess 9 regions firmly
How do you palpate for the liver?
Start in the RIF and move towards the costal margin asking patient to take deep breaths
in and out. Move your hand up with expiration (Note that on inspiration the liver moves down
in the abdomen, and this may assist you in feeling the liver edge in an enlarged liver).
How do you palpate for the spleen?
Stand up to examine the spleen. Start in the RIF and move toward the left costal
margin.
How do you palpate the kidneys?
Using both hands ballot the kidneys bilaterally
What are the different percussion findings in the abdomen?
bowel = resonant
organs = dull
distension = tympanic
fluid (ascites) = dull in flanks & shifts when rolled
What auscultation should you perform on the abdomen?
- bowel sounds
- aorta?
What further examinations should be considered?
- examination of groin
- PR exam
How should you end the abdominal exam?
- summarise
- thank patient
- wash hands
