1. Rangsima Poomsawat
Department of Public Health Nursing
Faculty of Nursing, Chiang Mai University
E mail : rangsima@chiangmai.ac.th
to_rangsima@hotmail.com
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11/29/2010 1rangsima@chiangmai.ac.th
2. GI Tract
Hx Taking
CC
PI
PH
FH
Personal Hx
PE
หลัก ขั้นตอน
Inspection
Auscultation
Percussion
Palpation
Laboratory
Special
Inv.
OBJECTIVE
11/29/2010 2rangsima@chiangmai.ac.th
22. C. Movement of the abdominal wall
Absolute fixation of the whole or most
part in generalized peritonitis
Diminished movement of some part in
inflammation of some certain organs
D. Movement beneath the abdominal wall
Visible peristalsis in GI tract obstruction
Visible pulsation of abdominal aorta in
thin abdominal wall
11/29/2010 22rangsima@chiangmai.ac.th
23. Listen for :
a. bowel sounds
frequency and character of bowel sounds-clicks
gurgles , borborygmi.
b. vascular sound : bruits , venous hums
c. friction rubs : Liver abscess
d. absence of bowel sounds – 5 Minute
e. succussion sounds in high gut obstruction
11/29/2010 23rangsima@chiangmai.ac.th
24. : Useful for general orientation of
abdomen ,
for measurement of liver and the spleen
for identification of air in the stomach and bowel
for revealing obliterated liver dullness
for determining ascites fluid thrill , shifting dullness
Percussion note :
a. Tympanitic d. Dull
b. Resonant e. Flat
c. Hyperresonant
11/29/2010 24rangsima@chiangmai.ac.th
