Abdominal

Assessment

Pictures - Talley & O’Connor, 2018

 Abdomen
Review of Systems (pg 12, Bates)
 Abdominal Pain
 Abdominal distension
 Heartburn / reflux
 Appetite change
 Weight loss / weight gain
 Nausea / vomiting
 Bowel changes
 Urinary symptoms
 Gyn changes
 Problems mouth/swallowing
Abdominal examination
Patient should lie flat with a pillow under
head / pillow under knees

Need to be undressed with the abdomen

fully exposed

Examine from the patients right hand side

2012
 Inspection
 Mouth and hands first
 Scars
 Striae
 Dilated veins
 Rashes/lesions
 Bruises
 Contour of abdomen
 Visible organs or masses
 Peristalsis
 Pulsations
 Abdominal Palpation
 Palpation
 Requires relaxed abdominal muscles.
Bend knees up slightly to relax
abdominal wall muscles.

 Lightpalpation of all four quadrants– try all

relaxing methods you know
 Deep palpation – using palmer surfaces of
fingers
 Liver Palpation
 Place
left hand behind the patient –
supporting the 11th and 12th rib

 Place your right hand on abdomen, lateral

to rectus muscle – ask pt to take deep
breath and try and feel liver edge
 Percussion
 Percuss abdomen in all four quadrants
listening for tympany or dullness.
 Auscultation

 Begin in R) lower quadrant – listen for 1 minute

 If absent move to another quadrant and listen
 If still absent move again
 Bickley 5 – 34 sounds per minute
 Talley & O’Connor presence or absence – listen
for 3 minutes.
Abnormal Bowel Sounds

High pitched tinking sounds = heard

in bowel obstruction

Increased bowel sounds can result

from gastroenteritis or bowel
obstruction

Decreased bowel sounds  absent

result from paralytic ileus &
peritonitis.
Assessing kidney tenderness
Percuss over costrovertebral angles (CVA’s).
Place one hand over the CVA and percuss
with ulnar surface of other hand.
 Discuss when needed
 Sexual health
 Groin examination
 Rectal/anal
 Inguinal – nodes/pulses/hernias/femoral
arteries