For a detailed walkthrough of abdominal examination, please see the Abdominal Examination article
INTRODUCTION…
·         Wash hands
·         Check patient name/DOB/hospital number
·         Introduce- My name is…”
·         Consent – Explain what your going to do;
o   I am going to have a look and a feel of your hands, face and abdomen. Is that ok?”
·         Chaperone
·         Confidentiality
·         Position – Flat
INSPECTION…
·         General (at end of bed): Medication, Discomfort, Abdomen Distended, Jaundice, Tattoos, Scars
·         Hands:Clubbing ,Leuconychia, Koilonychia , Palmar Erythema Asterixis (Flapping tremor)
·         Face &Neck: Angular stomatitis , Glossitis , JVP, Lymph Nodes
·         Chest: Spider naevi, Gynaecomastia, Ascites
PALPATION…
·         Ask patient if they have any areas of discomfort, if yes begin palpation away from this area &proceed cautiously.
o   Light & Deep- Palpate each region assessing for masses or abnormalities (See Diagram)
o   Liver, Kidneys, Spleen
PERCUSSION…
·         Technique- It’s all in the wrist. Practice, practice, practice!
·         Liver, Spleen, Kidneys, Bladder,
·         Assess for Ascites using Shifting Dullness/Fluid Thrill
AUSCULTATION…
·         Bowel Sounds
·         Renal Bruits
CONCLUSION…
·         “To conclude I would like to examine the external genitalia, hernial orifices, assess for ankle oedema, and perform a per rectal (PR) exam and urine dipstick
·         Thank patient
·         Cover up and check comfortable         
The 9 regions of the abdomen
 
Circle indicates area of kidney auscultation.
R/L HC –Hypochondrium
R/L L – Lumbar
R/L IF – Iliac Fossa
E – Epigastrium
U – Umbilical Region
SP – Suprapubic
                                  

For more information, see the abdominal examination page

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