Abdominal Examination

[Guest]

Ask the patient to lie supine with one pillow under their head.
Have their under wear half way between their symphisis pubis and the iliac crest. Ask the patient to take a deep breath and cough
Count to ten at look at the patient. Do a visual survey and look at the face for pallor, jaundice, Xanthelesma, parotid gland swelling, and pigmentation
Look at abdomen for spider naevi. gynecomastia, distended abdominal veins, abdominal distention and decreased body hair, tattoos, scratch marks and hernia.



Hands

Inspect for clubbing, leuconychia, palmar erythema. Feel for Duptryuens contracture. Check for asterixis

Face

Pull one eyelid down to look for anemia
Look a sclera for icterus, cornea for arcus, eyelids for xanthelesma, mouth for angular chelitis, HHT, Osler weber rendu (telengectsia),swollen lips (Crohns),patches of pigmention (Peutz-jeghers), chrons

Neck

Feel for supracavicular lymph nodes ( virchow's node on the left) with the patient lying.


Chest

Gynesomastia In obese patients palpate for glandular breast tissue
Also look for spider naevi and paucity of hair


Abdomen

Ask "Do you have any tenderness"
Lightly palplate all quadrants
Deep palpation of all quadrants- check for transplanted kidney in iliac regions
Liver: Palpate from the RIF upwards Try to get above Measure in fingerbreadths the distance from the costal margin
Spleen: From RIF Feel for notch. Measure in fingerbreadths from the costal margin Try to get above

Ballot kidneys: Ask the patient to roll to side put lower hand all the way beneath the patient

Precuss from the nipple down to determine the upper and lower limits of the liver and spleen

Precuss from midline to the left flank. If there is dullness in the flank then leave the finger over the dull area and ask the patient to roll toward you then precuss again for shifting dullness

Asculatate:- listen fro renal artery bruit and splenic rub

I would like to

Urine dipstick
Examine the external genitalia
Perform a P/R examination

[guest18]

Thanx:)