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    Examination of Abdominal Lump: DR Rajesh P S

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    drrajeshpsms
    This document provides guidance on examining an abdominal lump. It outlines the key steps of inspection, palpation, percussion, and auscultation of the abdomen. Specific characteristics are described to help identify potential lumps in the liver, spleen, stomach, kidneys, and other intra-abdominal or parietal masses. The examination aims to determine the location, size, shape, consistency, mobility, and underlying organs involved of any abdominal lump.

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    Examination of Abdominal Lump: DR Rajesh P S

    Uploaded by

    drrajeshpsms
    122 views20 pages
    This document provides guidance on examining an abdominal lump. It outlines the key steps of inspection, palpation, percussion, and auscultation of the abdomen. Specific characteristics are described to help identify potential lumps in the liver, spleen, stomach, kidneys, and other intra-abdominal or parietal masses. The examination aims to determine the location, size, shape, consistency, mobility, and underlying organs involved of any abdominal lump.

    Original Title

    Abdominal Lump

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    This document provides guidance on examining an abdominal lump. It outlines the key steps of inspection, palpation, percussion, and auscultation of the abdomen. Specific characteristics are described to help identify potential lumps in the liver, spleen, stomach, kidneys, and other intra-abdominal or parietal masses. The examination aims to determine the location, size, shape, consistency, mobility, and underlying organs involved of any abdominal lump.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    122 views20 pages

    Examination of Abdominal Lump: DR Rajesh P S

    Uploaded by

    drrajeshpsms
    This document provides guidance on examining an abdominal lump. It outlines the key steps of inspection, palpation, percussion, and auscultation of the abdomen. Specific characteristics are described to help identify potential lumps in the liver, spleen, stomach, kidneys, and other intra-abdominal or parietal masses. The examination aims to determine the location, size, shape, consistency, mobility, and underlying organs involved of any abdominal lump.

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    Examination of

    abdominal Lump
    Dr Rajesh P S
    • HISTORY
    • Symptomatology already dealt with
    • A lump is there
    Quandrants

    Midclavicular lines Hypochondrium (2)


    Transpyloric line Epigastrium
    Trans-tuberous line Lumbar (2)
    Umbilical
    Iliac fossa (2)
    Hypogastrium
    EXAMINATION OF THE ABDOMEN

    • Inspection
    • Position of the swelling
    • Skin over the swelling
    • Size shape
    • Movement with respiration
    • Liver ,GB, Spleen, stomach , kidneys and supra renal
    • Visible peristalsis
    • Position , time , light
    • Left to right – ca stomach
    • Right to left – ca transverse colon
    • Step ladder – small bowel obstruction
    • Hernial orifices
    • Scrotum / genitals
    • Left supraclavicular region
    • Troisier's sign
    Palpation

    • Deep palpation is required


    • Local temp
    • Tenderness
    • Size site shape Surface
    • Margin
    • Consistency
    • Movement
    • Movement with respiration
    • Movement in all direction
    • Ballottable
    • One hand is placed behind the loin and the other hand in front of the
    abdomen and the swelling is moved anteroposteriorly between the two
    hands. A renal swelling is 'ballottable'.
    • Plane of the swelling
    • Parietal /Intra-abdominal
    (i) to raise his shoulders from the bed with the arms folded over the chest —
    the 'rising-test' or
    (ii) to raise both the extended legs from the bed — the 'leg lifting test’
    (Carnett's test) or
    (iii) to try to blow out with his nose and mouth shut.
    (iv) if the swelling moves vertically with respiration it is obviously an intra-
    abdominal swelling.
    • Intraperitoneal or retroperitoneal
    • Knee chest position – falling forward or not
    • Pulsatile swelling / non pulsatile
    • expansile or transmitted pulsation
    • Look for expansile impulse on coughing
    • Palpate separately for liver spleen and kidney
    • Insinuation of finger into the costal margin
    • Percussion
    • Resonant / dull
    • Free fluid – shifting dullness / fluid thrill /puddle sign
    • Renal angle – resonant normally – dull in renal swelling
    • Auscultation
    • Bowel sounds
    • Absent / exaggerated – borborygmi
    • Bruit
    Different swelling

    • Liver
    • Right hypochondrium/epigastrium/ left hypochondrium
    • Cant insinuate
    • Movement with respiration
    • No intrinsic mobility
    • All borders not palpable
    • Sharp / round border
    • Intra-abdominal intra peritoneal
    • Percussion dull – continuous with that of liver dullness from chest
    • Spleen
    • Intra abdominal / intra peritoneal
    • Left hypochondrium
    • Cant insinuate
    • Free movement with respiration
    • No intrinsic mobility
    • Direction of growth towards right iliac fossa
    • Notch in the border
    • Percussion dull
    • Traube’s space dull – castell’s sign
    • Stomach
    • Epigastrium/ hypochondriums
    • Movement – not free on respiration
    • All borders
    • Can insinuate
    • Mobility – intrinsic may be there
    • Intra abdominal intra peritoneal
    • Percussion impaired
    • Kidney
    • Both lumbar region
    • Intra abdominal retro peritoneal
    • Mobility with respiration
    • Bimanualy palapable /ballottable
    • Percussion resonant
    • Renal angle dull
    Other masses ( intra abdominal )

    • Lymph nodes
    • Pancreas
    • Bowel mass
    • Aortic aneurysm
    • Gall bladder – better seen than felt
    • Retro peritoneal masses
    • Parietal masses
    • Lipoma
    • Sebaceous cyst
    • Hernias – epigastric / fatty hernia linea alba

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