· 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?”
· Position – Flat
· 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
· 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
· Technique- It’s all in the wrist. Practice, practice, practice!
· Liver, Spleen, Kidneys, Bladder,
· Assess for Ascites using Shifting Dullness/Fluid Thrill
· Bowel Sounds
· Renal Bruits
· “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