Examination of the Abdomen

1) General Visual Survey

a. Pallor Pigmentation
b. Tattoos
c. Fistulae
d. Abdominal surgery scars
e. Look around the bed for IV lines
f. Xantelasma, telengectasiae
g. Scratch marks
h. Parotid swelling
i. Brusing
2) Hands
1) leuchonechia
2) clubbing
3) palmar erythema
4) duputyres contracture
5) fistulae
6) flapping tremors
3) Face
a.
b.
c.
d.
e.
f.
g.
h.
i.

Anemia
Pallor
Xantelasma
Lips Swollen lips Chrons
Mouth oral ulcers Chrons
Telengectasiae osler weber rendu
Pigmentation puetz
Spider nevi
Parotid swelling

4) Neck
a. Lymph nodes If present check lyph nodes in the axilla and groin
5) Chest Wall
a. Gynecomastia
b. Spider nevus
6) Abdomen
a. Inspection
i. Look for obvious masses, herniae, scar marks, scratch marks,
distended viens
b. Palpation
i. Superficial palpation

1. Ask patient if he has pain

2. check in all 4 quadrants
ii. Deep palpation
1. start in the right iliac fossa move vertically up for liver
and diagonally for spleen
c. Percussion
i. Percuss from nipple down
ii. Percuss from resonant to dull in abdomen
iii. Check flanks if dull demonstrate shifting dullness
d. Auscultation
i. Aortic and renal Bruit
ii. Liver and Spleen Bruit
iii. Bowel Sounds
7) Look at the back of the patient!!!
Offer to complete examination by doing Per-rectal examination