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11_ABDOMEN

11_ABDOMEN

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Published by: api-19916399 on Dec 02, 2009
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03/18/2014

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1
1
Do you know that?
A good eater m ust be a good
man; for a good eater must
have good digestion, and
good digestion depends upon
a good conscience
2
Physical Examination
Physical Examination
Abdomen
LI U YANFANG,
M.D., Ph.D
1st Teaching Hospital
Henan Medical University
3
Surface Landmarks
Xiphoid process
of sternum
Anterosuperior
iliac spine
Superior margin
of os pubis
Costal margin
midline
umbilicus
Poupart
ligament
4
Organs in the Abdomen
5
Review of specific smptoms

\ue000PAIN
\ue000NAUSEA AND VOMITING
\ue000CHANGE IN BOWEL MOVEMENTS
\ue000RECTAL BLEEDING
\ue000JAUNDICE
\ue000ABDOMINAL DISTENTION
\ue000MASS
\ue000PRURITUS (ITCHING)

6
Inspection and palpation
Inspection and palpation
Landmarks and regions
Landmarks and regions
Inspection
Inspection
Palpation
Palpation
2
7
Surface Landmarks
Xiphoid process
of sternum
Anterosuperior
iliac spine
Superior margin
of os pubis
Costal margin
midline
umbilicus
Poupart
ligament
8
The four abdominal quadrants
The four abdominal quadrants
Two imaginar y
perpendicular lines
Four Quadrant s
Right upper
Right lower
Lef t upper
Lef t lower
9
The Nine Abdominal Areas
The Nine Abdominal Areas

1.Epigast r ic
2.Umbilical
3.Supr apubic
4.Right hypochondriac
5.Lef t hypochondriac
6.Right lumbar
7.Lef t lumbar
8.Right inguinal
9.Lef t inguinal

10
Inspection
\ue000Position : supine
\ue000Inspect downward
\ue000Contents

1.Contour
2.Respiratory movement
3.Abdominal skin. veins,
4.GI form\u80c3\u80a0\u578b

\u80c3\u80a0\u578b,
,P
Peristaltic wave\u8815\u52a8\u6ce2
\u8815\u52a8\u6ce2
11
Contour
\ue000Normal: flat to rounded
\ue000Abnormal: protuberant\u51f8\u51fa\u7684 abdomen,
abdominal distention\u8179\u90e8\u81a8\u80c0
Flat
Scaphoid\u821f\u72b6
Rounded
Protuberant
13
Organs in the Abdomen
3
14
Contour
Contour\u2014\u2014
\u2014\u2014Protuberant abdomen
Protuberant abdomen
\ue000Causes
Ascit es
Gases dist ent ion of t he int est ines
Or ganomegaly
Obesit y
16
Count our
Count our\u2014\u2014
\u2014\u2014Depr ession
\ue000
\ue000Regi onal
Regi onal
Scar
Scar
\ue000
\ue000Gener al
Gener al
S
Scaphoid abdomen
C
Cachexia\u6076\u75c5\u8d28
\u6076\u75c5\u8d28
Ear ly acut e dif f use per it onit is
Abdominal muscle spasmodic cont r act ion
17
Respiratory movement
Respiratory movement
\ue000
\ue000N orm al
N orm al
M ale and Children
M ale and Children\u2014\u2014
\u2014\u2014Abdom inal
Abdom inal
respiratory m ovem ent
respiratory m ovem ent
Fem ale
Fem ale\u2014\u2014
\u2014\u2014C h est resp irato ry
C h est resp irato ry
m ovem ent
m ovem ent
18
Abdominal Respiratory Movements
\ue000Decreased:
\u2013inflammational pain, volume expansion
\ue000Diminished/decreased:
\u2013Acute peritonitis, Enteroparalysis,Ascites, Mass,
\ue000Increased:
\u2013rib fracture, pleuritis (Pleural effusion)
Gastral or intestinal pattern, peristalsis\u2014
\u2014intestinal obstruction
19
I nspect t he Skin
I nspect t he Skin
For r edness pallor , j aundice, edema,
skin er upt ion, & Pyoder ma gangr enosum
20
I nspect t he Skin
I nspect t he Skin
Color
G rey-Turner\u2019s Sign:M assive ecckym oses occur on
the abdom en oron the flanksasa resultof
hem orrhagic pancreatitis or stangulated bow el.
Cullen\u2019s sign:A bluish discoloration ofthe um bilicus
resulting from hem operitoneum ofany cause.

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