i Abbmen tsanmiration

ch
11SUR bladde ennpty 2
Can uplerse lye down (supine posiion Om
Vth
D0 feelany pain
Tnspection
Noo lmgoing toinspet uRer gnerdl appeacance
Clingqaiely an ing with cis tamfort gvipping sne side)
1Noa sm nspecting the Surface lonto ursánd mo\erdent
abdomen Nu (nspecing the balges and paistalsis. .

Skin cheaking uR Skin oY tenmp coloY, Scats Stiae

dilatedtains and yashes.o
v tempwam, cool, clammny
v coloy buikes, eythema, Jaundice
Stiae pink -puple cu shing syndyome
"old silveprequney acada
dilated weinsimhosis Liaferior yena caye obstiuction
fechymesesiMerqeri tonedl. /ranopeitoneal hentanhage
Capillai es Splderagicias
Sptdekangioas a a b s
Umbilicu:
-Now inspeck locatton and tonteuts (shipeiSine)
sak- Jock for Any infammation /bulging due to Nential heinia
Contouy f the abdomen
vabdomen Size Aat/>ounded /Protub aant /Stameid
Theyeiis platlabdomen , nolcigns aflank local bulges
-Tt is symmetical.(Asyimmely Hernia /eh laiged Ongan )
No db dominal messes
atient
Poisalsis| Noymdlly visi ble in Very thin people
(movement Cif ke suspect thtestwal cbshvuctfon

Pulation-Nomal gortic pulsat(on, si sible Lh epiqastriunm

Auscaltation
’ Asu lHate Bt then pacusion , falpation bes2
bcs
bowel GoundomayaleY.
s Make Sure hant, Sthethostope warm enough
Cceld Sieth y may cUSe Cold weflexesNoluntaryiChages
in the freguency a bowelmouement) a
asAtscalkatefor bowel Sounds
- Now lm qoing to ausultatetiRabdomeninfo no h4
bowel Seund
Nomal clicks &qurglesitcob
5to 34 /mingag
Abno (hal Stomach.qowling Boyborygami
a prolanged guglesq hypespeistalsis.
dsaally istaning in RLQ nÈS Sujpüest
’Auseutlfate on AQuadantta
Auscaltate for bruits Ausutete
4 pelient has hypertengjan epl gcstriuma in
sdladakeau i c A e a c h UboerQuadiqnt
Auscultate for brits maor qrieries. fori britst
Z3gl I'n go11gto auscultate URu abdomiral aoYtar
yeral arteries, iliac arteryfo bruits
 DATE Agta
Auscu-tate o Sicftonal abé RenalA
oVeY (vex andspleen
Pexcussionn do bevcuséron ihac.A
’lm gcing to deleini he amount and st ibation
gasAl
tymphany pretorinkesbes gas hda
- bulness Scateed lhcsa,organ feces
’ percucs on all 4 Quadarant
Nous ('m giy to pecass all A Quadaiants
To asses uiscera abdormicd-masses.
Result
homal tishi bution a tymphany adulness and.
No sigasasctesabdomioal. masses wert noted
oSigng of pexuSiop tenda ness.
Palpatlon :
ght palpaion
ckeaking for any bdomina tenderhess, muscular dender ness
o any SubutaneOUs ma4er orlaisions.
-Resstance þreseat checkit is voluntary quarding
iNolantqvy rgiditya
Tovolun4ary guardin (then paPye)
-Can u piease 1elax and exhalk ?Bkto
thygvh of
Beath through cpen mouth
d feel any
 4-5cmL Path. PrÍ
dep
bcs: t hand f
Dees alpaton(4-5Cm ) Precsur
tlse hands (left By R )
tsmore difff cult oheset mus. tone
SNoANatarqet
cket 4he delinationogan is deep
- Now lim qoing to p t te hver edge kideeys
and abdomina masses
-Im going
Cdelinationchangecin Joeation)
toncheck
Check for
foY YeYe boynd
bound. tendeness
pin ofen plpati
tal pation

Do feelAny páin
palpate foy peri tonltiS 2 aute abdomen
-Signs y Perito ni 4is tue
ous (4o checki where cough produces pain)a
Riqi dity Per ussiontendernees
Reboundtnyelutary
tendenes
voluntay tertraction Reflex Cotreclin

Peicssion. LVE
Ro2u0300Au
" Nou I'm geing to peicuss the borders the iver
Using mordaateike(beç:a heae heavier S vike
Can leado Uinderestimat iver Size )es
louweYy bordev Imidchv.
line

fxom: below Umbilies in RLQ

Move Upuwardk tn mjd clavicula (ine

Sound: tymp hany dulness.
*Uppe orde DATE NO.

From: nipple Jine

sala move oushujarddsaha
Sound Resonance to dulnesstic
(tung)
" chranic obshiuetive fulmonary dis.liver dalsess my displaced doanuuard chy louek
In mìddavicarine b-12 tm diaphragm
In mid SternalLine ( &-Scom
Tn
6-1)4g
if liver Seems enlanged,
-out lie the lower bader (edge by pexcusing mi alliy latly
Palpation:
(Ip. hand - behind tne pt ’ Suppord to Il,2 nbs)
iDwer liveY edge : 3p} yelax on hand
-USe RA hqnd
ist exhale
palpate on RE abdomen (lat to rechus mus)
pelpate then tnlale

too
Don't palpate bea the RtCostamaigin YK msing lowei
liygy that extended into RLQ ege
qenlayed live
Notnal Iivex edge Saft Shaxp egular Smooth Surfate
Mau be sligktly tende
iver
3m
UPWard palpable above cm beloua the nght toastal magia
in mìddaitular ine
Can pk4se brath though dR abdomen
(if u can't feel the edqe ’ move uR hand closer to
coastal margtn aty)
 carefully for an

ies
raw
DATE. NO.
Hoo King techniq ue :
-obese partient
loc: R abdomen belouw the boxder of iver dullness
(A
with uR fngerk up toluard o
- press in
the Co46ta margin
Can, U pleasetake deep byeathi
ter
(Palalion S aba
isc bothshand

percassion At Axtina eyfound

st- ercuss in louest interspac tn

Vsi GORrCHsSio AntAx.ne

Palprtien
d leftcide
Doc. If-hand Under the pt hip
- Paation
ise tyaube
Space leosial
fts Megin aainiabd-(toke deup krat
n
Kdny NormaCant pohate
of test fox pylonephYitis
perCussion ni ksats a d t t
a
-costo vetebral angletenderness.
St
- Soc. If. kand ( finge ips -pt cvA.
ty
a -boc: Rt handunch
Aorta
-deep tn epiga4ium
b
- Slightly left of mid line
aWide -scn
VCI and gall
 DATE NO.

O Aates

Shiftir dlness

yetcitis’Ask pt to eery test po fet any Aain?

Rovsing sign (L)
oaeslRsoas sigh (Kree)
Lobturatóx imernel otat

Aute
kep breath Press RUQ chdey casiad nargin)
Nental Heania
pt vaise both head and sholder t t abk