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    Abdominal PEP

    Uploaded by

    Randy Turner
    This document provides guidance on performing an abdominal examination, including important anatomical landmarks, patient positioning, and the proper order and technique for inspection, auscultation, percussion, and palpation. The examination should systematically evaluate the skin, umbilicus, abdominal contour, visible organs, pulsations, and sounds. Percussion helps assess the liver and spleen size while palpation checks for tenderness, the liver, and spleen. Special tests evaluate for fluid, masses, and abdominal issues.

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    Abdominal PEP

    Uploaded by

    Randy Turner
    177 views7 pages
    This document provides guidance on performing an abdominal examination, including important anatomical landmarks, patient positioning, and the proper order and technique for inspection, auscultation, percussion, and palpation. The examination should systematically evaluate the skin, umbilicus, abdominal contour, visible organs, pulsations, and sounds. Percussion helps assess the liver and spleen size while palpation checks for tenderness, the liver, and spleen. Special tests evaluate for fluid, masses, and abdominal issues.

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    How to do an Abdominal PEP

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    This document provides guidance on performing an abdominal examination, including important anatomical landmarks, patient positioning, and the proper order and technique for inspection, auscultation, percussion, and palpation. The examination should systematically evaluate the skin, umbilicus, abdominal contour, visible organs, pulsations, and sounds. Percussion helps assess the liver and spleen size while palpation checks for tenderness, the liver, and spleen. Special tests evaluate for fluid, masses, and abdominal issues.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    177 views7 pages

    Abdominal PEP

    Uploaded by

    Randy Turner
    This document provides guidance on performing an abdominal examination, including important anatomical landmarks, patient positioning, and the proper order and technique for inspection, auscultation, percussion, and palpation. The examination should systematically evaluate the skin, umbilicus, abdominal contour, visible organs, pulsations, and sounds. Percussion helps assess the liver and spleen size while palpation checks for tenderness, the liver, and spleen. Special tests evaluate for fluid, masses, and abdominal issues.

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    © All Rights Reserved
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    The document outlines the proper technique for performing an abdominal exam, including inspection, auscultation, percussion, and palpation in that order. It also describes anatomical landmarks and patient positioning.

    The steps of a proper abdominal exam are inspection, auscultation, percussion, and palpation in that order. Inspection focuses on the skin, umbilicus, and abdominal contour. Auscultation listens for bowel sounds.

    The components of percussion in an abdominal exam are assessing the amount and distribution of gas to identify masses, and specifically assessing the size of the liver and spleen. Percussion is done in all four abdominal quadrants.

    Abdominal Examination

    Anatomic Landmarks
    Anterior

    Xiphoid process to symphysis pubis

    Inguinal ligaments

    Anterior superior iliac spines

    Costal margins

    Posterior

    11th and 12th ribs

    Costovertebral angle

    Other

    Mid-axillary and mid-clavicular lines

    Proper Positioning

    Supine, flat on table - insert hand under back to check

    Arms at sides or folded across chest not overhead

    Before exam, have patient point to areas of pain

    Monitor exam by watching patients face for signs of discomfort

    Examine from right side (systematic, traditional, etc.)

    Inspection-Auscultation-Percussion-Palpation is the proper order for an abdominal exam.


    Inspection

    Skin note scars, striae, dilated veins, rashes and lesions.

    Umbilicus contour, location, any inflammation or bulges.

    Contour of the abdomen symmetry, is the abdomen flat, rounded, protuberant, or scaphoi
    (markedly concave or hollowed)?

    Are there visible organs or masses? Look for an enlarged liver or spleen that has descende
    below the rib cage.

    Bulging flanks - ascites.

    Pulsations normal aortic pulsation is frequently visible in the epigastrum, RV, liver, other.

    Auscultation - Listen for abdominal sounds with the diaphragm of the stethoscope in all four
    abdominal quadrants before any palpation or percussion. Normal sounds consist of clicks and
    gurgles, approximately 3 34 times per minute.

    Auscultation for abdominal bruits (over the aorta, illiac arteries and the femoral arteries).

    Percussion

    General:
    Assess amount and distribution of gas, identify masses (tympany vs. dullness)

    Specific:

    Assess size of liver and spleen

    Traubes space left costal margin, mid-axillary line, 6 th ICS

    Shifting dullness

    Percuss the abdomen in all four quadrants (at least these 4 locations, more if there is a problem).
    Can go from top to bottom or bottom to top. Will mostly hear tympany, but will hear dullness from
    fluid and feces.
    Percussion of the liver span:
    Start at a level below the umbilicus (in an
    area of tympany, not dullness). Lightly
    percuss upward toward the liver. Ascertain
    the lower border of the liver dullness in the
    midclavicular line. Next, identify the upper
    border of liver dullness in the midclavicular
    line. Lightly percuss from lung resonance
    down toward liver dullness. Now measure in
    centimeters the distance between the two
    points the vertical span of liver dullness.
    (4-8 cm in midsternal line, 6-12 cm in right
    midclavicular line).

    Percussion of Traubes Space: (two techniques for detecting splenomegaly). See arrows for
    suggested routes of percussing the spleen.

    Palpation:

    Palpate areas of pain last

    Observe face of patient for signs of discomfort

    Cycle of light palpation followed by deep

    Check for rebound tenderness

    Liver

    Spleen

    Light Palpation

    Deep Palpation

    Palpation of the liver

    Special Tests:

    Scratch Test
    Shifting Dullness
    Fluid Wave
    Rovsings Sign
    Psoas Maneuver
    Obturator Sign
    Murphys Sign
    Assessing for Possible Ascites

    Palpation of the spleen

    Assessing for Shifting Dullness

    Assessing for a Fluid Wave

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