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DeGowin's Diagnostic Examination, 9e
Physical Examination of the Abdomen
Sections: The Abdomen, Inspection, The distended abdomen, Auscultation, Percussion, Palpation, Posture of the patient, Light abdominal palpation, Deep abdominal palpation, Attributes of masses, Palpation of the LUQ, Palpation of the RUQ, Palpation of the lower quadrants, Examination of the abdomen and pelvis per rectum and vagina, Examination for abdominal hernias, Zieman inguinal examination, Examination of the Perineum, Anus, Rectum, and Distal Colon, Inspection of the perineum, Examination of the Anus, Anal palpation, Anoscopy, Examination of the Rectum, Rectal palpation, Examination of the Sigmoid Colon.
Topics Discussed: abdomen; abdominal examination; abdominal mass; abdominal swelling; anogenital region; anorectum; anus; bimanual examination; iliopsoas muscle; left upper quadrant pain; obturator internus muscle; palpation of abdomen; percussion of abdomen; proctoscopy; rectal examination; rectovaginal examination; rectum; sigmoid colon; spleen; ventral hernia.
Excerpt:"The abdomen is examined in the following sequence: inspection, auscultation, percussion, and palpation. Ensure a warm room and adequate covering so that the patient does not chill and tense the abdominal wall. The patient should lie supine with a pillow under the head. A pillow under the knees, to support passive hip and knee flexion, may add additional comfort and relax the abdominal wall muscles. When orthopnea is present, raise the backrest to support the trunk. Patients with kyphosis require more elevation of the head and shoulders. Drape the abdomen with a sheet or blanket, covering the lower limbs up to the pubes (Fig. 9–4). Cover a woman's breasts with a folded towel or gown. Examination is best performed from the patient's right side.Do not slight this step because of an urge to start palpating. Effort and discipline are required to inspect properly, thoroughly, and unhurriedly (Fig. 9–5). Arrange a single source of light to shine across the abdomen toward you, or, alternatively, have the light shine lengthwise over the patient. Inspect the abdomen sequentially for contour, distention, scars, engorged veins, visible peristalsis, and masses. Additional inspection from the foot of the table can reveal asymmetry of the abdomen and thorax.Experience..."
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