Gastro Exam Flashcards
(13 cards)
Introduction
- Wash hands
- Introduce
- Patient details
- Permission: Today I have been asked to perform a gastrointestinal examination - this will involve me having a look, a feel and a listen to your abdomen. We have our examiner here as chaperone. Does that sound okay?
- Exposure - waist upwards
- Reposition - 45 degree -> 180 degrees when get to abdomen
- Any questions? Any pain?
General inspection
Inspection from the end of the bed looking for
- Obvious anaemia, jaundice, tattoos, distension or scars, medical paraphernalia around bed
- Asked about any tattoos or bruises
- Gets patient to cough/lift head off the bed
Hands and arms inspection?
Leukonychia, koilonychia, Dupuytren’s contracture, palmar erythema, tattoos, excoriation, petechiae, haemodialysis fistulae
Hands and arms
Clubbing
Liver flap (30 seconds)
Cap refill
Radial pulse
Blood pressure
Face
Eyes - Conjunctival pallor, Scleral icterus, corneal arcus
Mouth - Pigmentation, Telangiectasia, Hydration, Dentition, Apthous ulcers, Angular stomatitis,
Atrophic glossitis, candidiasis
Neck
Left supraclavicular lymph node (Virchow’s Node) for Troisier’s sign (full neck lymph node examination)
JVP (+ hepatojugular reflex)
Acanthosis nigricans
Chest inspection
Scars, Spider naevi (presses them), gynaecomastia, abnormal hair distribution
Abdomen inspection
Scars, distension, caput medusa, pulsations, Cullen’s and Grey-Turner’s sign, striae, stomas/nephrostomies
Abdomen palpation
Light and deep palpation all 9 quadrants
Palpate liver
Palpate spleen
Ballot kidneys
Palpate AAA
Abdomen percussion
Percuss liver
Percuss spleen
Percuss bladder
Percuss shifting dullness
Abdomen auscultation
Bowel sounds
Bruits (Kidneys, Aorta, Liver)
Other?
Sacral + pedal oedema
To conclude
THANK, CLEAN HANDS AND STETHOSCOPE, OFFER TO HELP DRESS
To complete - check hernial orifices, examine external genitalia, DRE, urine dipstick
