Abdominal Exam Course

Abdominal Exam• Lying flat in bed

• Arms at sides, legs flat

• Avoid hands behind the head– Tightens abdominal muscles

• Place pillow behind the knees, stand on patient’s right side

• Examine the area of pain last

Abdominal Exam• Inspection

• Auscultation

• Percussion

• Palpation

• Rectal Exam

• Special Techniques

Abdominal Exam

Abdominal Structures

Referred Pain

Inspection• General Appearance

• Skin, Hands

• Facies

• Abdomen

• Hernias

• Superficial Veins

Jaundice

Osler-Rendu-Weber Syndrome

Cushing’s Syndrome

Pyoderma Gangrenosum

Lindsay’s Nails

Gynecomastia

Spider Angiomata

Enlarged Gallbladder

Hepatomegaly

Ascites

Umbilical Hernia

Abdominal Venous Pattern

Inspection

Inspection

Sister Mary Joseph’s Nodule

Auscultation• Bowel Sounds

• Rule out Obstructed Viscus

• Rule out Abdominal Bruits

• Rule out Peritoneal Rubs

Succussion Splash

Percussion• Percuss Abdomen

• Percuss Liver

• Percuss Spleen

• Rule out Ascites

Liver Percussion

Shifting Dullness

Shifting Dullness

Testing for Fluid Wave

Palpation• Light

• Deep

• Liver

• Spleen

• Kidney

Deep Palpation

Hooking the Liver

Location of Kidneys

Rectal Exam• Positioning

• Technique

• Palpate rectal walls

• Palpate prostate

• Test stool for occult blood

Rectal Exam

Special Techniques• Iliopsoas Test

• Obturator Test

Iliopsoas Test

Obturator Test

Questions