Abdominal

Question 1

Inspect

Answer 1

Shape, symmetry, distension (pulsating masses, hernia, peristaltic waves)
Fat, Faeces, Foetus, Flatus, Fluid 
Colour- rashes, spider nevi, striae 
Greys turner - Flank bruising 
Cullens - umbilical bruising

Question 2

Auscultate

Answer 2

Listen for bowel sounds in each of the 4 quadrants for up to 2 minutes
excessive- infection
absence- impaction, gut paralysis
tinkling - bowel obstruction

aortic or renal bruits

Question 3

Palpate

Answer 3

Light and deep palpation- masses/ distension
look for the patients reaction. any guarding or tenderness
palpate the aorta - ensure diameter less than 3 cm

kidneys - breathe in and feel - not normally palpable
- percuss for pain- pyelonephritis

Question 4

Percuss

Answer 4

areas of hypo and hyper resonance. check for ascites - shifting dullness or fluid wave

liver - scratch test/ percussion to feel for enlargement. palpate for masses. 6-12 at midclavicular line

spleen - upper L quadrant under ribs- should not be dull if not enlarged (infection, cirrhosis, liver disease) . not normally palpable.
Kehrs sign- L shoulder pain- rupture

Question 5

Murphy’s test

Answer 5

2 fingers under rib cage, pain on inspiration + gall bladder pain

Question 6

McBearney’s point

Answer 6

1/3 distance from superior iliac crest - pain = positive

Question 7

Psoas sign

Answer 7

flex R knee against resistance pain = positive

Question 8

Rovsing’s sign

Answer 8

pain in RLQ when palpating LLQ

Question 9

Obturator

Answer 9

Raise R leg with knee flexed and rotate internally. pain = positive