01. ASSESSMENT OF THE ABDOMEN NRS 102. PPT

1. Health Assessment Across the Lifespan

2.  Structure and Function
 Subjective Data—Health History Questions
 Objective Data—The Physical Exam
 Abnormal Findings
Slide 21-2

3.  Surface landmarks
 Borders of abdominal cavity
 Abdominal muscles
 Internal anatomy (viscera)
 Solid viscera
 Liver
 Pancreas
 Spleen
 Adrenal glands
 Kidneys
 Ovaries
 Uterus
Slide 21-3

4.  Internal anatomy (viscera) (cont.)
 Hollow viscera
 Stomach
 Gallbladder
 Small intestine
 Colon
 Bladder
Slide 21-4

5. Slide 21-5
© Pat Thomas, 2006.

6. Slide 21-6
© Pat Thomas, 2006.

7.  Abdominal wall divided into four quadrants
 Right upper (RUQ)
 Left upper (LUQ)
 Right lower (RLQ)
 Left lower (LLQ)
Slide 21-7

8. Slide 21-8

9.  Appetite
 Dysphagia
 Food intolerance
 Abdominal pain
 Nausea/vomiting
 Bowel habits
 Abdominal history
 Medications
 Nutritional assessment
Slide 21-9

10.  Preparation
 Lighting and draping
 Measures to enhance abdominal wall relaxation
 Equipment needed
 Stethoscope
 Small centimeter ruler
 Skin-marking pen
 Alcohol swab
Slide 21-10

11. Inspect the abdomen
 Contour
 Symmetry
 Umbilicus
 Skin
 Pulsation or movement
 Hair distribution
 Demeanor
Slide 21-11

12. Slide 21-12

13. Auscultate the abdomen
 Bowel sounds
 Vascular sounds
(bruits)
Percuss the abdomen
 General tympany
 Liver span
 Usual technique
 Scratch test
 Splenic dullness
 Costovertebral angle
tenderness
 Special procedures
 Fluid wave
 Shifting dullness
Slide 21-13

14. Palpate the liver
 Measures to enhance muscle
relaxation
 Light palpation
 Deep palpation
 Bimanual palpation
 Normally palpable structures
 Liver
 Usual technique
 Hooking technique
 Spleen
 Kidneys
 Aorta
Slide 21-14

15.  Rebound tenderness (Blumberg’s sign)
 Inspiratory arrest (Murphy’s sign)
 Iliopsoas muscle test
 Obturator test
Slide 21-15

16. Slide 21-16

17. Slide 21-17

18. Slide 21-18

19.  Obesity
 Air or gas
 Ascites
 Ovarian cyst
 Pregnancy
 Feces
 Tumor
Slide 21-19

20.  Umbilical hernia
 Epigastric hernia
 Incisional hernia
 Diastasis recti
Slide 21-20

21.  Hypoactive bowel sounds
 Hyperactive bowel sounds
Slide 21-21

22.  Enlarged liver
 Enlarged nodular liver
 Enlarged gallbladder
 Enlarged spleen
 Enlarged kidney
 Aortic aneurysm
Slide 21-22