Abdominal Examination 1. Introduction and Consent Wash your hands and don PPE Introduce yourself to the Patient Confirm who the patient is Explain the examination and gain consent Expose the patient and identify if the patient is in any pain 2. General Inspection From the End of the Bed…. What signs might you see? Walking Aids Surgical Drains Medications Feeding Tubes Discomfort/Pain Assess Observations/Fluid Balance Abdominal Distension Pallor Jaundice Oedema Stoma Bag 3. Inspection Hands Palms Pallor Palmar Erythema Dupuytren’s Nails Koilonychia Leukonychia Clubbing Tremor 3. Inspection Arms and Axilla Face Bruising Angular Stomatitis Excoriations Glossitis Needle Track Marks Oran Candidiasis Acanthosis Nigricans Apthous Ulceration Hair Loss Hyperpigmented Macules 3. Inspection Chest Abdomen Spider Naevi Scars Gynacomastia Distension Hair Loss Caput Medusae Striae Hernia Cullens/Grey Turner Sign Stomas 4. Palpate Light Palpation followed by Deep Palpation Tenderness Rebound Tenderness Organ Palpation Liver Gallbladder Murphey’s Sign Guarding Spleen Rovsing’s Sign Kidneys Masses Aorta Location Size +Shape Consistency Mobility Pulsatility Bladder 5. Percuss 6. Auscultate Liver Bowel Sounds Spleen Bladder Shifting Dullness (Ascities) Normal Tinkling Absent Bruits Aortic Renal 7. Completion of Examination Finally look at the legs Signs of pitting oedema Completion of The Examination Thank the Patient Dispose of PPE Wash your hands Summarise Findings Further Assessment Hernial Orifices External Genitalia PR
