Physical Examination of the Abdomen

Question 1

indications for examination of the abdomen

Answer 1

• Pain
• trauma
• diffuse pain
• concomitant ilness or malaise
• changes in appetite, digestion, bowel or bladder dysfunction
• complaints of malaise

Question 2

what to ask with abdomen pain or problems

Answer 2

• what were you doing when this pain began
• have you ever had a pain like this before
• Addition rule in/rule out areas

Question 3

Pain assessment of abdominal pain

Answer 3

• quanitity: 0-10 may need to know if they are exagerating
• quality: descriptors that may be used to figure out strucutres involved

Question 4

What can abdominal symptoms by influenced by

Answer 4

• respiration
• micturition

Question 5

Physical examination: inspection

Answer 5

• changes in superficial skin
• bulges
• contour
• incisions
• lift head off table to activate abs- does anything change
• diastasis recti/hernia
• are they splinting

Question 6

Ascultation of the abdomen

Answer 6

• listen to all quadrnats
• listen for bruits (aortic aneurysm)
• listen for liver friction rub (leathery)
• listen for venous hum over umbilicus - problelm with liver or kidney cause high pressures which can be heard as a hum

Question 7

Percussion of the abdomen exam

Answer 7

• tympany: over hallow structures
• Dullness: over solid structures
• Resonance: vibration
• looking over borders of organs

Question 8

Percussion pattern in abdomen exam

Answer 8

• right upper quadrant: liver
• left upper quadrant: spleen
• kidneys - rib angles
• may want to start or not start in area that is painful

Question 9

Palpation in abdomen exam

Answer 9

• same pattern
• first pass light: get a feel for contour/superficial layer
• second pass deeper
• third pass if needed
• may need to use breathing to get to deep structures
• iliopsoas is a common area for abscess and may need to palpate
• Pt should be in hooklying for exam

Question 10

Things to consider with the abdomen exam

Contraindications for BP

Answer 10

• preplanning is key
• equipment needed or available
• accuracy of euipment
• positioning of patient and yourself
• things that might alter readings
• contraindications for BP: IV, shunt, skin graft, blood clots, vascular compromised

Question 11

Documentation of vitals

Answer 11

• side
• location
• position
• at rest or with what MET level
• timing in activity
• SO2 sat on room air or with O2 including rate of flow