Abdominal Examination

Question 1

Summarise key steps

Answer 1

-Introduction
-Inspection
HANDS, EYES, MOUTH, LEGS

-Palpation -Organomegaly
-Percussion
-Assess for Ascites
-Auscultation
-Closure

Question 2

Inspection

Answer 2

-Assess for scars, bruising, jaundice
-Spider naevia, caput medusae (cluster swollen veins)

Question 3

Palpation

Answer 3

(patient lying down on bed)

LIGHT Palpation
**ask patient if have any pain on abdomen- avoid these areas
-Palpate abdomen with a flat hand all X9 areas of the abdomen (superficially) -butterfly flutter technique

DEEPER PALPATION
-Palpate all X9 quadrants Deeper palpation

Question 4

Assess for Organomegaly

Answer 4

Liver:
-Start in the RIF,
-Scoop upwards on right side to feel if enlarged
*RIF-bottom right
MUST ASK PATIENT BREATH IN AN OUT (SCOOP FOR VERY INSPIRATION)

Spleen:
-Place hand in the RIF > move towards LIF as patient breathes in and out

Kidneys:
-Place one hand over kidney and palpate (each side)

Question 5

Percussion

Answer 5

Liver- RIF and 5th intercostal space (top liver) downwards
-Spleen- RIF > LIF

Question 6

Assessment for Ascites
(percuss- tap)

Answer 6

Percuss at the flank side of the abdomen for dullness (fluid)
-Roll patient towards you and re-percuss, has the dullness shifted?
*if yes- fluid is present

Question 7

Auscultation

Answer 7

Bowel sounds

Question 8

How is palpation done?

Answer 8

(Hand flat and then bend in knuckles but like a flutter