Abdominal Examination Flashcards
(7 cards)
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
