Introduction to Abdominal Exam

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This article provides a very brief overview of abdominal examination. For a detailed walkthrough, 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 the patient is comfortable

Abdominal quadrants and regions

The abdomen can be divided into 4 quadrants or 9 regions as per the image below:

Abdominal quadrants and regions
Abdominal quadrants and regions

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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