curve over the top of the upper pole of the left kidney.

has two functional endocrine portions, the cortex and the medulla
-

- found at the level of the 12th thoracic vertebra. The cortex mainly produces cortisol, aldosterone and androgens, while the medulla chiefly produces epinephrine and norepinephrine.

Left Kidney

(Upper Pole)

- located high and deep under the diaphragm - protected by the posterior rib cage - filtrates and eliminates metabolic waste products - controls blood pressure and maintains water, salt and electrolyte balances - functions as endocrine glands by secreting hormones

Left Ureter
- runs behind the peritoneum from the renal hilum to the posterior aspect of the bladder - passageway that carry urine from the kidneys to the bladder

located mostly behind the stomach deep in the upper abdomen long gland extending across the abdomen from the RUQ to the LUQ not palpable Functions: Endocrine gland
Accessory

organ of

digestion

SPLEEN
- approximately 7 cm wide - located above the left kidney just below the diaphragm at the level of the ninth, tenth and eleventh ribs - posterior to the left midaxillary line and posterior and lateral to the stomach - not palpable - filters the blood of cellular debris, digests microorganism and returns the breakdown to the liver - stores RBCs and platelets, produces RBCs and macrophages, activates B and T lymphocytes

SPLENIC FLEXURE OF COLON

- is a bend in the colon

STOMACH

- is on the left side of the abdominal cavity, nearly hidden by the liver and diaphragm

- the stomach has a third oblique layer of muscle in its wall that allows it to perform mixing or churning movements

TRANSVERSE COLON
- lies across the abdominal cavity

 Left

Kidney (Lower Pole) - located below the diaphragm and posterior to the spleen - protected by the posterior rib cage - filtrates and eliminates metabolic waste products - controls blood pressure and maintains water, salt and electrolyte balances - functions as endocrine glands by secreting hormones

 Left

Ovary and Tube ovary - is located in the lateral wall of the pelvis in a region called the ovarian fossa. - secrete both estrogen and progesterone tube forms the initial part of the duct system. - allows passage of the egg from the ovary to the uterus

Left Ureter

- passageway that carry urine from the kidneys to the bladder

Left Spermatic

Cord

- Connective tissue sheath which encloses a tube called vas deferens, along with blood vessels and nerves

Descending/Sigmoid

Colon
-colon that is extended downward along the left side of the abdomen Sigmoid colon- curve toward the midline -often felt as a firm structure on palpation - lies in the pelvis *primarily secretes large amounts of alkaline mucus to lubricate the intestine, leaving waste products to be eliminated in stool

BEFORE

Ask the client to urinate since an empty bladder makes the assessment more comfortable. Ensure that the room is warm since the client will be exposed. Introduce self and verify the clients identity using agency protocol. Explain procedure. Perform hand washing. Provide for client privacy. Know clients history

DURING

Assist client to supine position, with the arms placed comfortable on both sides. Place small pillows beneath the knees and the head. Expose the clients abdomen only from the chest line to the pubic area.

Inspect the abdomen for skin integrity. Inspect the abdomen for contour and symmetry. Observe abdominal movements.

Observe the vascular pattern.

Auscultate the abdomen for bowel sounds. Percuss several areas in each of the four quadrants to determine presence of tympany and dullness.

Percuss the liver to determine its size. Perform light palpation first to detect areas of tenderness and/or muscle guarding.

Perform deep palpation over all four quadrants. Palpate the liver to detect enlargement and tenderness. Palpate the area above the pubic symphysis if the clients history indicates possible urinary retention.

AFTER
Document

findings in the client record using forms

or checklists supplemented by narrative notes when appropriate.

Perform Report

a detailed follow-up examination.

significant deviations from normal to the

primary care provider.