Abdominal Examination Flashcards
ABDO Initial, hands, arms, face
GEL HANDS
Intro, check patient ID, explain and consent
Ask about pain
Adjust bed height and arrange at 45 degrees
Environment; fit and well? O2, sputum pot/sick bowl?
Hands; anaemia, leukonychia, koilynechia, clubbing, tar staining, palmar erythema, pale palmar crease, Duptryen’s contracture
Arms; scratch marks, track marks, muscle wastage, skin turgor, bruising, pulse and resp rate
TREMOR; flapping or fine
Face; parotid swelling, eyes jaundice/anaemia, sore red tongue, angular stomatitis of anaemia, feotor hepaticus
ABDO Lymph nodes, chest, legs
Lymph nodes; Careful of scalene node on left
Chest; Hair loss and gynocomastae (males), spider naevi
Legs; erythema nodosum, hair loss, peripheral oedema
Abdomen Inspection
Patient supine, from end of bed
- visible pulsation aorta
- movement with resp
- stoma
- striae
- abdo shape; scaphoid or obese
- petechiae
- caput medusae
- bruising
- scars
- skin lesions
- scratch marks
- abdo distension
Abdominal palpation
Sit down so hand can be flat, ask about pain
If in pain, begin away from site of pain
Light palpation; LOOKING AT PATIENT’S FACE, rebound tenderness, tender, abnormal masses, guarding
Deep palpation; LOOKING AT FACE tenderness that wasn’t present on light palpation
Palpate for organs; liver, spleen, kidneys
Abdominal percussion
Percuss up to liver and to spleen listening for change from resonant to dull - explain if liver low then check actually low
Percuss for fluid
- shifting dullnes
- fluid thrill
Abdominal auscultation
Bowel sounds lower left flank - if not heard would listen for two minutes
Aortic bruits, renal bruits, hepatic and splenic bruits & rubs
ABDO Ending
Explain not complete without examination hernial orifices, groins, male genitals and DRE
Thank patient, replace bed and allow to get comfortable again
GEL HANDS
