ABDOMINAL EXAMINATION

Question 1

BOWEL SOUNDS OF ABDOMEN

Answer 1

POSITIVE: Listen for frequency and character INDICATES: 1. hyperactive ( > 35/min) 2. Normoactive (5-35/min) 3. Hypoactive (1-4/min) 4. Absent (0 bowel sounds, but you must listen for 5 continuous minutes) - Medical emergency (obstruction or perforation)

Question 2

FRICTION RUBS

Answer 2

POSITIVE: High pitched sandpaper rubbing sound associated with respiration INDICATES: Inflammation of peritoneal surface of the liver and/or spleen from infection, tumors, or infarct

Question 3

MAJOR ARTERIES OF THE ABDOMEN FOR BRUITS

Answer 3

POSITIVE: Harsh, musical choosing sound (bruit) INDICATES: Possible vascular disease

Question 4

VENOUS HUM IN THE ABDOMEN

Answer 4

POSITIVE: Soft, low pitched, continuous sound that is louder during diastole INDICATES: Increased collateral venous circulation

Question 5

SCAN ABDOMINAL REGIONS FOR TONE

Answer 5

POSITIVE: Detect the presence of fluid, air, or solid masses INDICATES: Size and shape of the organs

Question 6

PERCUSS THE URINARY BLADDER

Answer 6

POSITIVE: Dullness of suprapubic area INDICATES: Distended bladder

Question 7

PERCUSS THE LIVER FOR SIZE

Answer 7

NORMAL: Usual span of liver is approximately 6-12 cm (2 1/2 to 4 1/2 in) INDICATES: A span greater than this may indicate liver enlargement (hepatomegaly) A lesser span may suggest atrophy

Question 8

PERCUSS FOR GASTRIC AIR BUBBLE

Answer 8

POSITIVE: Tympany INDICATES: Location of the fundus of the stomach

Question 9

PERCUSS THE SPLEEN

Answer 9

POSITIVE: Dullness INDICATES: Location of the spleen and/or splenomegaly

Question 10

LIGHT PALPATION OF THE ABDOMEN

Answer 10

POSITIVE: Pain, tenderness, muscle guarding, and masses

Question 11

DEEP PALPATION OF THE ABDOMEN

Answer 11

POSITIVE: Pain, tenderness, muscle guarding, and masses

Question 12

DISTINGUISH A SUPERFICIAL FROM A DEEP MASS

Answer 12

POSITIVE: 1. Mass remains visible and/or palpable 2. Mass is no longer visible and/or palpable INDICATES: 1. Superficial Mass 2. Deep Mass

Question 13

PALPATE FOR LIVER EDGE USING STANDARD MANEUVER

Answer 13

POSITIVE: Nodules, tenderness, irregularity INDICATES: Liver Disease

Question 14

GALLBLADDER PALPATION

Answer 14

POSITIVE: Increased pain and reflex apnea (Murphy’s SIGN) INDICATES: Cholecystitis

Question 15

PALPATE FOR SPLEEN

Answer 15

POSITIVE: Palpable Spleen INDICATES: Splenomegaly

Question 16

PALPATE AROUND THE UMBILICUS

Answer 16

POSITIVE: Bulges, nodules, and or irregularities INDICATES: Possible abdominal hernia

Question 17

PALPATE THE ABDOMINAL AORTA PULSE

Answer 17

POSITIVE: Prominent lateral pulsation INDICATES: Possible aortic aneurysm

Question 18

PERFORM KIDNEY ENTRAPMENT

Answer 18

POSITIVE: Increased pain over the kidney INDICATES: Nephritis

Question 19

PALPATE THE URINARY BLADDER

Answer 19

POSITIVE: Smooth rounded dense mass INDICATES: Distended bladder

Question 20

BLUMBERG’S SING

Answer 20

POSITIVE: Sharp pain upon rebound in any of the 4 quadrants INDICATES: Peritonitis

Question 21

ROVSING’S SIGN

Answer 21

POSITIVE: Sharp pain upon rebound in the right lower quadrant when pressing into the left lower quadrant INDICATES: Appendicitis

Question 22

TEST FOR ASCITES: FLUID WAVE

Answer 22

POSITIVE: Easily detected fluid wave INDICATES: Ascites (pathological increase of fluid in the abdomen)

Question 23

PSOAS SIGN

Answer 23

POSITIVE: Increased pain in Right Lower Quadrant

Question 24

OBTURATOR SIGN

Answer 24

POSITIVE: Increased pain in right lower quadrant INDICATES: Ruptured appendix or pelvic abscess

Question 25

MURPHY’s PUNCH

Answer 25

POSITIVE: Increased pain over the kidney INDICATES: Nephritis of inflamed kidney