Abdomen mich

The digestive system or tract is basically
a long tube that begins with the mouth or
oral cavity, and ends at the anus. There
are five function under the digestive
system, each function corresponds to
each organ of the systems. These are the
following. INGESTION, SECRETION,
DIGESTION, ABSORPTION and
EGESTION
( DEFECATION)

 Ingestion is the process of carrying food
into the digestive tube through the oral
cavity, organs under this process are ( oral
cavity, tongue, teeth, salivary glands,
esophagus).
 Secretion is the process wherein different
chemicals and enzymes are being
released by the organs to aid in digestion
and absorption of nutrients, organs under
this function are( stomach, liver, gall

 Digestion is the process wherein the food
is being process by the stomach to be
absorbed by the body, organ under this
process is the stomach.
 Absorption is the process of absorbing all
the nutrients provided by the food that is
being ingested, organs under this process
are small intestine { duodenum, jejunum,
ileum } and the large intestine { appendix
and colon {ascending, transverse and

 The GI tract is a 23- to 26-foot-long pathway that
extends from the mouth through the esophagus,
stomach, and intestines to the anus THE FOUR BASIC
TUNICS ON THE TUBE ( MUCOSA + SUBMUCOSA +
MUSCULARIS + SEROSA)
 esophagus -is located in the mediastinum in the
thoracic cavity, anterior to the spine and posterior to
the trachea and heart(25 cm long)
 stomach -is situated in the upper portion of the
abdomen to the left of the midline, just under the left
diaphragm. It is a distensible pouch with a capacity
of approximately 1500mL.

 Stomach- can be divided into four
anatomic regions: the cardia (entrance),
fundus, body, and pylorus (outlet).
 small intestine- is the longest segment of
the GI tract, accounting for about two thirds
of the total length.
 small intestine- is divided into three
anatomic parts: the upper part, called the
duodenum; the middle part, called the
jejunum; and the lower part, called the

ORGANS AND FUNCTIONS
 large intestine - consists of an ascending
segment on the right side of the abdomen,
a transverse segment that extends from
right to left in the upper abdomen, and a
descending segment on the left side of the
abdomen. The terminal portion of the large
intestine consists of two parts: the sigmoid
colon and the rectum. The rectum is
continuous with the anus.

 The liver is situated in the top part of the
abdomen on the right side of the body next
to the stomach. It is the largest gland in the
body, weighing almost 2 kg. is the major
detoxicating organ in the body; it destroys
harmful organisms in the blood, produces
clotting agents, secretes bile, stores
glycogen and metabolises proteins,
carbohydrates and fats

 gall bladder- a sac situated underneath
the liver, in which bile produced by the liver
is stored.
 Pancreas- a gland which lies across the
back of the body between the kidneys. It
has two functions: the first is to secrete the
pancreatic juice which goes into the
duodenum and digests proteins and
carbohydrates; the second function is to
produce the hormone insulin which
regulates the use of sugar by the body

 Spleen - an organ in the top part of the
abdominal cavity behind the stomach and
below the diaphragm, which helps to
destroy old red blood cells, form
lymphocytes and store blood.
 Appendix- a small tube attached to the
caecum which serves no function but can
become infected, causing appendicitis.

ABDOMEN

Abdominal Quadrants

ABDOMEN

Organs of the Abdominal Cavity

ABDOMEN

Abdominal Quadrants and the Underlying Organs

ABDOMEN

Nine Abdominal Regions

ABDOMEN

Landmarks Commonly Used to Identify Abdominal Areas

ABDOMEN NORMAL FINDINGS ` DEVIATION FROM
NORMAL
Inspect the abdomen Unblemished skin. Presence of rash or other
for skin integrity lesions.
Uniform color
Tense, glistening skin
Silver-white striae (may indicate ascites,
(stretch marks) or edema).
surgical scars
Purple striae (associated
with Cushing’s disease)

DEVIATION FROM
ABDOMEN NORMAL FINDINGS
NORMAL
Inspect the Flat, rounded (convex), Distended
abdominal or scaphoid (concave)
contour (profile
line from the rib
margin to the
pubic bone) while
standing at the
client’s side while
the client is in
dorsal recumbent
position
Inspect for an No evidence of Evidence of enlargement
enlarge liver or enlargement of the of the liver or spleen
spleen liver or spleen
•Ask client to take a
deep breath and hold
breath to observe for
organ enlargements
and abdominal
distention

DEVIATION FROM
NORMAL
Assess the symmetry Symmetric contour Asymmetric contour
of contour while (localized protrusions
standing at the foot around the umbilicus,
of the bed inguinal ligaments, or
scars) possible hernia
• If distention is present, or tumor.
measure abdominal girth,
by placing tape measure
around the umbilicus

DEVIATION FROM
NORMAL
Inspect the Symmetric movements Limited movement due
abdominal caused by respirations. to pain or disease
movements process.
associated with Visible peristalsis in
respirations, very lean people Visible peristalsis in
peristalsis, or aortic nonlean clients (with
pulsations Aortic pulsation in thin bowel obstruction)
person at the epigastric
area
Observe vascular No visible vascular Visible venous pattern
patterns pattern (dilated veins)
associated with liver
disease, ascites and
venocaval obstruction.

DEVIATION FROM
NORMAL
Auscultate the Audible bowel sounds. Absent, hypoactive, or
abdomen for bowel hyperactive bowel
sounds, vascular Absence of bruits. sounds.
sounds, and Loud bruit over aortic
peritoneal friction Absence of friction rub. area (possible
rub. aneurysm).
Bruit over renal or iliac
arteries.

Sites for Auscultating the Abdomen

AUSCULTATING THE ABDOMEN
•Warm the hands and the stethoscope diaphragms.
•FOR BOWEL SOUNDS
– Use the flat disc diaphragm. Intestinal sounds are relatively high
pitched and best accentuated by the flat disc diaphragm.
– Ask when the client last ate. Shortly after or long after eating,
bowel sounds may normally increase. They are loudest when a
meal is long overdue. 4-7 hours after a meal, bowel sounds
maybe heard continuously over the ileocecal valve area while the
digestive system empty through the valve into the large intestine.
– Listen for active bowel sounds ---irregular gurgling noises
occurring about every 5 to 20 seconds
– Normal bowel sounds are described as audible, 5-34 bowel
sounds per minute
– High pitched, loud, rushing, sounds that occur frequently (e.g.
every 3 seconds) also known as BORBORYGMI
– True absence of sounds (none heard in 3 to 5 minutes) indicates
cessation of intestinal motility.

AUSCULTATING THE ABDOMEN
– Hypoactive bowel sounds indicate decreased motility and are usualy
associated with manipulation of the bowel during surgery, inflammation,
paralytic ileus or late obstruction.
– Hyperactive bowel sounds indicate increased intestinal motility and are
usually associated with diarrhea, an early bowel obstruction or the use od
laxative
•FOR VASCULAR SOUNDS
– Use the bell of the stethoscope over the aorta, renal arteries, iliac
arteries, and femoral arteries
– Listen for bruits ( blowing sound due to restricted blood flow
through narrowed vessels)
•FOR PERITONEAL FRICTION RUB
– Peritoneal friction rub are rough, grating sounds like two pieces of
leather rubbing together.
– Friction rubs may be caused by inflammation, infectious or
abnormal growths

DEVIATION FROM
NORMAL

Percuss several Tympany over the Large dull areas
areas in each of the stomach and gas-filled (associated with
four quadrants. bowels; dullness, presence of fluid or
especially over the liver tumor)
•Begin in the LLQ  and spleen or full
RLQ  RUQ LUQ bladder

ABDOMENMEN NORMAL FINDINGS DEVIATION FROM
NORMAL

Percuss span of liver Normal liver span is Firm edge of cirrhosis
dullness in the 4-8 cm in midsternal Increased in
midclavicular line line and 6-12 cm in hepatomegaly
(MCL) right midclavicular
line

ABDOMEN

PERCUSSING LIVER SPAN

ABDOMEN

4-8 cm in
midsternal line

6-12cm in right
midclavicular
line

Percussing the Area Over the Symphysis Pubis

DEVIATION FROM
NORMAL

Perform light No tenderness, relaxed Tenderness and
palpation followed by abdomen with smooth, hypersensitivity.
deep palpation of all consistent tension.
Superficial masses.
four quadrants
Tenderness maybe Localized areas of
present near the increased tension
xiphoid process, over
Generalized or
cecum, and sigmoid
localized areas of
colon
tenderness
Mobile or fixed
masses.

PALPATING THE ABDOMEN
LIGHT PALPATION
•To check for muscle tone and tenderness
• Place the hand with fingers together parallel to the area being
palpated. Press down 1 to 2 cm. Repeat in ever-widening circles until the
area to be examined is covered.
• If patient is excessively ticklish, begin by pressing your hand on top of
the client’s hand while pressing lightly. Then slide your hand off the
client’s and onto the abdomen to continue the examination.

DEEP PALPATION
•To identify abdominal organs and abdominal masses.
•Palpate sensitive areas last.
•With fingers together, approach the area to be examined at a 60 degree
angle and use the pads and tips of the fingers of one hand to press in 4
cm.

ABDOMEN

TWO-HANDED DEEP PALPATION

ABDOMEN

Assess for Peritoneal inflammation
1. Before palpation, ask the patient to cough and
determine where the cough produced pain.

2. Then, palpate gently with one finger to map the
tender area.

• Abdominal pain on coughing or with light percussion
suggests peritoneal inflammation

ABDOMEN

3.If not, look for rebound tenderness. Press your fingers in
firmly and slowly, and then quickly withdraw them.

4.Watch and listen to the patient for signs of pain.

5.Ask the patient (A) to compare which hurt more, the pressing
or the letting go, and (B) to show you exactly where it hurt.

Pain induced or increased by quick withdrawal constitutes
rebound tenderness. Rebound tenderness suggests peritoneal
inflammation.

ABDOMEN

ABDOMEN Normal Deviation form Normal

Palpate the liver.

Feel the liver edge,as the No enlargement of the Firm edge of cirrhosis
patient breathes in. liver

Note any tenderness or
masses No tenderness Tender liver 0f hepatitis or
congestive heart
failure;tumor mass

ABDOMEN

PALPATING THE LIVER

ABDOMEN

Palpate the spleen.

Place the patient in a supine No enlargement and splenomegaly
position and let her lay on tenderness of the spleen
the fight side with legs
flexed at the hips and knees

ABDOMEN

PALPATING THE SPLEEN

ABDOMEN

Palpate each kidney A normal right kidney may Enlargement from cysts,
be palpable, especially in cancer, hydronephrosis.
thin, well-relaxed women Bilateral enlargement
suggests polycystic disease

Tender in kidney infection
Non-tender.
Check for costovertebral
angle (CVA) tenderness

ABDOMEN

PALPATION OF
THE RIGHT
KIDNEY

ABDOMEN

PALPATING
FOR CVA
TENDERNESS


ASSESSING ASCITES In a person without In ascites, dullness shifts to
ascites, the borders the
Palpate for shifting between tympany and more dependent side,
dullness. dullness while tympany
usually stay relatively shifts to the top
constant.

Map areas of tympany and
dullness with patient supine
then lying side

ABDOMEN

Tympany

Tympany

Dullness Dullness

TEST FOR SHIFTING DULLNESS


ASSESSING ASCITES

Check for a fluid wave. Negative for fluid wave. An easily palpable impulse
(No impulse is transmitted suggests
Ask patient or an assistant when you tap one flank ascites.
to press edges of both sharply)
hands into the midline of
abdomen. Tap one side and
feel for a wave transmitted
to the other side.

ABDOMEN
ASSESSING FOR POSSIBLE IN CLASSIC AppendicitiS:
APPENDICITIS

Ask:

Where did the pain begin? Near the umbilicus

Where is it now? Right lower quadrant

Ask the patient to cough:”where does
it hurt?” Right lower quadrant
Palpate for local tenderness. RLQ tenderness

Palpate for muscular rigidity. RLQ rigidity

ABDOMEN
Check for Rovsing’s sign and for referred Pain in the right lower quadrant
rebound tenderness. during left-sided pressure suggests
appendicitis (a positive Rovsing’s sign). So
(Press deeply and evenly in the left lower does right lower quadrant pain on
quadrant. Then quickly withdraw your quickwithdrawal (referred rebound
fingers.) tenderness).

Look for a psoas sign. Increased abdominal pain on either
maneuver constitutes a positive
Place your hand just above the patient’s psoas sign, suggesting irritation of
right knee and ask the patient to raise the psoas muscle by an inflamed
that thigh against your hand. appendix.
Alternatively, ask the patient to turn onto
the left side. Then extend the patient’s
right leg
at the hip. Flexion of the leg at the hip
makes the psoas muscle contract;
extension stretches it.

ABDOMEN
Look for an obturator ‘s sign. Right hypogastric pain constitutes
a positive obturator sign,
suggesting irritation of the obturator
Flex the patient’s right thigh at the hip, muscle by an inflamed
with appendix.
the knee bent, and rotate the leg
internally at the hip. This maneuver
stretches the internal obturator muscle.


Inspect :

A. abdomen with the infant protuberant
lying supine

B. newborn’s umbilical cord two thick-walled umbilical A single umbilical artery
arteries and one larger but may be
thin-walled umbilical vein, associated with congenital
which is usually located at anomalies,
the 12 o’clock position but also occurs in normal
infants as an isolated
anomaly


C. Area around the No redness or swelling Umbilical hernias in infants
umbilicus for redness or are due
swelling to a defect in the
abdominal wall,
and can be up to 6 cm in
diameter
and quite protuberant
when intraabdominal
pressure is increased
.


Auscultate for bowel There is an orchestra of An increase in pitch or
sounds musical tinkling bowel frequency
sounds every 10 to 30 of bowel sounds is heard
seconds. with Gastroenteritis
or, rarely, with intestinal
Obstruction.

A silent, tympanic,
distended abdomen
Percuss an infant’s Note greater tympanitic suggests peritonitis.
abdomen as you would for sounds due to the infant’s
an adult propensity to
swallow air

ABDOMEN Normal Deviation form
Normal
Palpate the infant’s liver.

Start gently palpating the liver Palpable 1-2 cm below the An enlarged tender
of infants low right costal margin liver may be due to
in the abdomen, moving congestive heart
upwards with your failure
fingers .

ABDOMEN

ABDOMINAL ASSESSMENT OF AN
INFANT

ABDOMEN

EARLY AND LATE CHILDHOOD,AND
ADOLESCENCE

Toddlers and young children commonly have
protuberant abdomens, most apparent when
they are upright. The examination can follow
the same order as for adults, except that you
may need to open your bag of tricks to distract
the child during the examination.

ABDOMEN

GERIATRICS

Same assessment as the adult


Inspect any scars or striae, Purplish striae and linea Scars may confirm the type
the shape and contour of nigra are normal in of prior
the abdomen, and the pregnancy. surgery, especially
Fundal height. cesarean section.
The shape and contour
may indicate pregnancy
size
Palpate the abdomen for:

A. Organs or masses.

The mass of pregnancy is
expected.

B.Fetal movements. These can usually be If movements cannot be
felt by the examiner felt after 24 weeks,
after 24 weeks consider error in
(and by the mother at calculating gestation,
18–20 weeks) fetal death or morbidity,
or false pregnancy

C. Uterine contractility.. The uterus contracts Prior to 37 weeks,
irregularly after 12 regular uterine
weeks and contractions with or
often in response to without pain
palpation during the or bleeding are
third trimester abnormal, suggesting
preterm labor.

ABDOMEN

MEASUREMENT OF THE FUNDAL
HEIGHT

ABDOMEN

D. Measure the fundal After 20 weeks, If fundal height is more
height with a tape measure measurement in than 2 cm higher than
if the woman is more than centimeters should expected, consider
20 weeks’ pregnant roughly equal the weeks multiple gestation, a big
of gestation. baby,
Holding the tape as extra amniotic fluid, or
illustrated and following the uterine myomata. If it is
midline of the abdomen, lower than expected by
measure from the top of more than 2 cm,
the symphysis pubis to the consider missed abortion,
top of the uterine fundus. transverse
lie, growth retardation, or
false pregnancy.

ABDOMEN

36 wks
32 wks
28 wks
24 wks
20-22 wks
16 wks
12-14 wks

EXPECTED HEIGHT OF THE
UTERINE FUNDUS BY MONTH OF
PREGNANCY


Auscultate the fetal heart, The rate is usually in the Lack of an audible fetal
noting its rate (FHR), 160s during early heart may
location, and rhythm. pregnancy, and then slows indicate pregnancy of
Use either: to the 120s to 140s near fewer weeks
term. After 32 to 34 than expected, fetal
weeks, the FHR should demise, or
increase with fetal false pregnancy.
A doptone, with which the movement.
FHR is audible after 12 FHR that drops noticeably
weeks, or near term with fetal
movement
A fetoscope, with which it could indicate poor
is audible after 18 weeks placental
circulation.

ABDOMEN

DOPTONE (LEFT) AND FETOSCOPE (RIGHT)

ABDOMEN

MODIFIED LEOPOLD’S MANEUVERS
These maneuvers are important adjuncts to palpation of the pregnant
abdomen beginning at 28 weeks of gestation.

They help determine where the

A. fetus is lying in relation to the woman’s back (longitudinal or
transverse)
B. what end of the fetus is presenting at the pelvic inlet (head or
buttocks),
C. where the fetal back is located, how far the presenting part of the
fetus has descended into the maternal pelvis
D.the estimated weight of the fetus.

ABDOMEN

FIRST MANEUVER (UPPER POLE).
Stand at the woman’s side facing her head. Keeping the
fingers of both examining hands together, palpate
gently with the fingertips to determine what part of
the fetus is in the upper pole of the uterine fundus.

ABDOMEN

SECOND MANEUVER (SIDES OF THE MATERNAL
ABDOMEN)

Place one hand on each side of the woman’s
abdomen, aiming to capture the body of the
fetus between them. Use one hand to steady
the uterus and the other to palpate the fetus.

ABDOMEN

Third Maneuver (Lower Pole).
Turn and face the woman’s feet.

Using the flat palmar surfaces of the fingers of both
hands and, at the start, touching the fingertips
together, palpate the area just above the symphysis
pubis. Note whether the hands diverge with downward
pressure or stay together. This tells you whether or not
the presenting part of the fetus, head or buttocks, is
descending into the pelvic inlet.

ABDOMEN

Fourth Maneuver (Confirmation of
the Presenting Part).

With your dominant hand grasp the part of the
fetus in the lower pole, and with your
nondominant hand, the part of the fetus in
the upper pole. With this maneuver, you may
be able to distinguish between the head and
the buttocks.

Source:

BATES’GUIDETOPHYSICALEXAMIN
A T I O N A N D H I S T O R Y T A K I NG

PREPARED BY:
EMIL ANTHONY LUCAS, R.N.
GAYLE BERONGOY, R.N.

Blood tests are ordered initially. Common
blood tests include
 complete blood count (CBC),
carcinoembryonic antigen (CEA), liver
function tests, serum cholesterol, and
triglycerides. Test findings may reveal
alterations in basal metabolic function and
may indicate the severity of a disorder

SPECIAL PREPARATION
 CONFIRM THE DOCTORS ORDER
 INSTRUCT THE PATIENT FOR THE
PROCEDURE
( NOTHING PER OREM FOR HOW MANY
HOURS DEPENDING ON THE KIND OF
BLOOD WORKS e.g 8 hours, 10 or 12 hours
)

COMPLETE BLOOD COUNT
 Number of white blood cells (WBC)
 Total amount of hemoglobin in the blood (Hgb).
 Fraction of blood composed of red blood cells (Hct).
 Volume of Hgb in each RBC (MCV [mean corpuscular
volume]).
 Weight of the Hgb in each RBC (MCH [mean corpuscular
hemoglobin]).
 Proportion of Hgb contained in each RBC (MCHC [mean
corpuscular hemoglobin concentration]).
 Number of platelets, which are critical to clot formation

LIVER FUNCTION TEST
 A panel of tests used to evaluate liver function.
Includes:
 ◆ Alanine aminotransferase (ALT)
 ◆ Alkaline phosphatase (ALP)
 ◆ Aspartate aminotransferase (AST)
 ◆ Bilirubin
 ◆ Albumin
 ◆ Total protein

■ Used in the evaluation of symptoms
associated with liver disease (jaundice,
nausea, vomiting and/or diarrhea; loss of
appetite; ascites, hematemesis, melena;
fatigue or loss of stamina; history of alcohol
or drug abuse

 Fecal Occult Blood (FOB, Stool for Occult Blood)
(Negative)
 Stool sample
 Used to detect microscopic bleeding into the GI tract.
 Routine screening test for patients over 50 years old.
 Positive in ulcers, polyps, hemorrhoids, tumors,
inflammatory bowel disease, diverticulosis, and other
disorders of the GI tract.

 Stool Culture (Stool for C&S, Stool for Ova
 and Parasites [O&P])
 Normal intestinal flora
 Small amount of stool specimen in a sterile container
with a screw-top lid.
 Evaluate cause of diarrhea.

SPECIAL CONSIDERATION
 ENSURE CLEANLINESS OF THE SPECIMEN CUP
 ALWAYS USE GLOVES IN COLLECTING THE
SPECIMEN
 SEND IT IMMEDIATELY TO THE LABORATORY
AFTER GETTING THE SPECIMEN
 NOTE FOR THE DIET OF THE APTIENT FOR
THE PAST 24 HOURS

Imaging studies include x-ray and
contrast studies, computed
tomography (CT) scans, magnetic
resonance imaging (MRI), and
scintigraphy (radionuclide
imaging).

 Upper Gastrointestinal Tract Study
X-rays can delineate the entire GI tract after
the introduction of a contrast agent. A
radiopaque liquid (eg, barium sulfate) is
commonly used. The patient ingests this
tasteless, odorless, nongranular, and
completely insoluble (hence, not
absorbable) powder in the form of a thick or
thin aqueous suspension for the purpose of
studying the upper GI tract

NURSING INTERVENTIONS
 The patient may need to maintain a low-residue diet
for several days before the test.
 He or she should receive nothing by mouth after
midnight before the test.
 The physician may prescribe a laxative to clean out the
intestinal tract.
 Because smoking can stimulate gastric motility, the
nurse discourages the patient from smoking on the
morning before the examination.
 In addition, the nurse withholds all medications.

Lower Gastrointestinal Tract Study
 When barium is instilled rectally to
visualize the lower GI tract, the procedure is
called a barium enema. The purpose of a
barium enema is to detect the presence of
polyps, tumors, and other lesions of the
large intestine and to demonstrate any
abnormal anatomy or malfunction of the
bowel

Computed Tomography
CT provides cross-sectional
images of abdominal organs
and structures. Multiple x-ray
images are taken from many
different angles, digitized in
the computer, reconstructed,
and then viewed on a
computer monitor.
Indications for abdominal CT
scanning are diseases of the
liver, spleen, kidney,
pancreas, and pelvic organs.

 The patient should not eat or drink for 6 to 8
hours before the test.
 The practitioner may prescribe an
intravenous or oral contrast agent.
 Therefore, the nurse should question the
patient about contrast dye allergies.

Magnetic Resonance Imaging
It is a noninvasive technique that uses magnetic
fields and radiowaves to produce an image of
the area being studied. The use of oral contrast
agents to enhance the image has increased the
application of this technique for the diagnosis
of GI diseases. It is useful in evaluating
abdominal soft tissues as well as blood vessels,
abscesses, fistulas, neoplasms, and other
sources of bleeding.

 The patient should not eat or drink for 6 to 8
hours before the test.
 Before the test, the patient must remove all
jewelry and other metals.
 It is important to warn patients that the
close-fitting scanners used in many MRI
facilities may induce feelings of
claustrophobia

ULTRASOUND
A NON INVASIVE PROCEDURE THAT USE
HIGH FREQUENCY SOUND THAT CAN
ESTABLISH THE STRUCTURE, SIZE OF
ORGAN OF THE ABDOMEN
 WIPE OF THE EXCESS LUBRICANT OVER
THE EXAMINED AREA

Endoscopic procedures used in GI tract
assessment include fibroscopy/
esophagogastroduodenoscopy, anoscopy,
proctoscopy, sigmoidoscopy, colonoscopy,
small-bowel enteroscopy, and endoscopy
through ostomy.

Upper Gastrointestinal Fibroscopy/
Esophagogastroduodenoscopy
FIBROSCOPY of the upper GI tract allows direct visualization
of the esophageal, gastric, and duodenal mucosa through a
lighted endoscope.
ESOPHAGOGASTRODUODENOSCOPY (EGD), is especially
valuable
when esophageal, gastric, or duodenal abnormalities or
inflammatory,
neoplastic, or infectious processes are suspected.
This procedure also can be used to evaluate esophageal and gastric
motility and to collect secretions and tissue specimens for further
analysis.

Anoscopy, Proctoscopy, and Sigmoidoscopy
The lower portion of the colon also can
be viewed directly toevaluate rectal
bleeding, acute or chronic diarrhea, or
change in bowel patterns and to
observe for ulceration,
fissures,abscesses, tumors, polyps, or
other pathologic processes

Fiberoptic Colonoscopy
 Direct visual
inspection of the
colon to the cecum
is possible by means
of a flexible
fiberoptic
colonoscope

PARACENTESIS
 procedure of draining fluid from a cavity inside the
body using a hollow needle, either for diagnostic
purposes or because the fluid is harmful. Also
called tapping
Biopsy
the process of taking a small piece of living tissue for
examination and diagnosis The biopsy of the
tissue from the growth showed that it was benign

Abdomen mich

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