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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;
  • I am going to have a look and a feel of your hands, face and abdomen. Is that ok?”
  • Chaperone
  • Confidentiality
  • Position – supine – lying flat on back on the bed

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.
  • Light & Deep- Palpate each region assessing for masses or abnormalities (See Diagram)
  • Liver, Kidneys, Spleen

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

 

Key

  • 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

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