Monday, 25 May 2009

Basic Examination of the Abdomen

General Inspection
  • Jaundice
  • Distension
  • Pain
  • Discomfort
  • Purpura
  • Spider naevi (more than 5)
Hands
  • Clubbing
  • Palmar Erythema
  • Dupuytren's contracture
  • Flapping tremor
  • Leuconychia
  • Koilonychia
Face
  • Jaundice - sclera
Mouth
  • Angular stomatitis
  • Glossitis
  • Ulcers - herpetic
  • Telangiectasia
  • Candidiasis
  • Gingivitis
Chest and Axillae
  • Gynaecomastia
  • Hair loss
  • Spider naevi
Abdomen
  • Distension - fluid, fat, flatus, foetus, faeces
  • Herniae
  • Scars
  • Striae
  • Distended veins
  • Pulsations
Palpation
  • Superficial and deep palpation
  • 9 regions - R. hypochondrium, L. hypochondrium, Epigastric, R. lumbar, L. lumbar, Umbilical, R. iliac fossa, L. iliac fossa, Suprapubic
  • Guarding
  • Tenderness (rebound = peritonitis)
  • Masses
  • Enlarged organs
  • Abdominal aorta - aneurysm
  • Ballot kidneys
Percusssion
  • Enlarged organs
  • Shifting dullness
Auscultation
  • Bowel douns - absent? tinkling?
  • Abdominal aortic bruits
  • Renal bruits
Back
  • Inspection - spider naevi, scars etc.
  • Cervical lymphadenopathy
  • Renal tenderness
Other Tests
  • Digital Rectal Examination
  • External genitalia
  • Herniae
  • Distended bladder?
  • Obs chart
  • Urine dipstix

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