ASSESSING ABDOMEN
ASSESSMENT PROCEDURE
INSPECTION
Observe the coloration of the
skin
Note the vascularity of the
abdominal skin
Note any striae
Inspect for scars. Document
the location by quadrant and
reference lines, shape, length
and any specific
characteristics.
Assess for lesions and rashes
Inspect the umbilicus. Note
the color of the umbilical
area.
Observe umbilical location
Assess contour of umbilicus
Inspect abdominal contour
Assess abdominal symmetry.
Look at the abdomen as the
client lies in a relaxed supine
position.
Inspect abdominal movement
when the client breathes
AUSCULTATION
Auscultate for bowel sounds
Auscultate for vascular
NORMAL FINDING
Abdominal skin is paler.
Scattered fine veins may be
visible.
New striae are pink or bluish
in color, ild striae are silvery,
white, linear and uneven.
Pale ,smooth, minimally
raised old scars may be seen.
Abdomen is free of lesions or
rashes. Flat or raised brown
moles, however , are normal
and may be apparent.
Umbilical skin tones are
similar with abdominal skin
tones or even pinkish.
Midline at lateral line.
Inverted or protruding no
more than 0.5 cm and is
round or conical.
Abdomen is flat, rounded or
scaphoid and should be
evenly rounded.
Abdomen is symmetric.
Respiratory movements may
be seen.
A series of intermittent, soft
clicks and gurgles are herad
at a rate of 5- 30 per minute.
Bruits are normally heard.
ABNORMAL FINDING
Purple discoloration at
the flanks, yellow hue of jaundice, pale
taut skin may be seen with ascites,
redness may indicate inflammation,
bruises or areas of local discoloration
are also abnormal.
Dilated veins, dilated surface arterioles
and capillaries with central star may be
seen.
Dark bluish pink striae.
Non-healing wound, redness,
inflammation, deep irregular scars may
be seen.
Changes in moles including size, color
and border symmetry. Bleeding moles
or petechiae (reddish or purple) are
abnormal.
Bluish or purple discoloration.
Deviated umbilicus.
Everted umbilicus and enlarged everted
umbilicus.
Protuberant and distended abdomen.
Abdomen is assymetric.
Diminished abdominal respiration or
change to thoracic breathing.
Hyperactive and hypoactive bowel
sounds are heard.
A bruit with systolic and diastolic
sounds
Listen for venous hum using
the bell of the stethospe in
the epigastric and umbilical
areas.
Auscultate for a friction rub
over the liver and spleen
PERCUSSION
Percuss for tone. Lightly and
systematically percuss all
quadrants.
Percuss the span or height of
the liver by determining its
lower and upper borders.
Percuss the spleen
Perform blunt percussion on
the liver and the kidneys.
PALPATION
Observe aortic pulsation.
Perform light palpation to
identify areas of tenderness
and muscular resistance.
Deeply palpate all quadrants
to delineate abdominal
organs and detect subtle
masses.
Palpate for masses. Note
their location, size (cm),
shape, consistency,
demarcation, pulsatility ,
tenderness and mobility.
Palpate the umbilicus and
surrounding area for
swellings, bulges, or massess
Palpate the aorta
components occurs.
Venous hum is not normally Venous hum in epigastric and umbilical
heard in epigastric and areas.
umbilical areas
No friction rub over lvier and Friction rub is heard.
spleen is present.
Generalized tympany Accentuated tympany or
predominates over the hyperresonance is heard over a
abdomen. Dullness is heard gaseous distended abdomen.
over the liver and spleen.
The lower border of liver The liver is in the higher or lower
dullness is located at the position than normal.
coastal margin to 1-2 cm
below. The upper border of
liver dullness is located
between the left fifth and
seventh intercoastal spaces.
Spleen is an oval area of The area of dullness is greater than 7
dullness approximately 7 cm cm.
wide.
No tenderness is elicited. Tenderness elicited.
A slight pulsations of the Vigorous, wide, exaggerated pulsations
abdominal aorta, which is may be seen.
visible in the epigastrium,
extends full length in thin
people.
Nontender and soft and no Involuntary reflex guarding.
guarding.
Tenderness is possible over Severe tenderness or pain.
xiphoid, aorta, cecum,
sigmoid colon and ovaries.
No palpable masses. Mass is detected.
Free of swellings, bulges or Palpation of hard nodue.
masses.
With moderately strong and Wide bonding pulse may be felt and
regular pulse. Possibly mild prominent, laterally pulsating mass

Palpate the liver
Palpate the spleen.
Document the size of the
spleen in centimeters below
the lft costal margin and also
note consistency and
tenderness.
Palpate the kidneys
Palpate the urinary bladder
tenderness may be elicited.
Firm, smooth, and even can
be felt at the lower edge.
Mild tenderness is also
normal.
Edge of the spleen is soft and
nontender.
Feel firm, smooth and
rounded. May or may not be
slightly tender.
An empty bladder is neither
palpable nor tender.
above the umbilicus with an
accompanying audible bruit.
Hard firm liver and tenderness may be
felt.
Splenic notch is felt. Feels firm and
sharp.
Smooth rather than sharp edge,
absence of a notch, and overlying
tympany on percussion.
Distended bladder is palpated as
smooth, round and somewhat firm. Can
be validated by dull percussion tones.