ASSESSMENT OF THE ABDOMEN GASTROINTESTINAL SYSTEM Health Assessment
ASSESSMENT OF THE ABDOMEN (GASTROINTESTINAL SYSTEM) Health Assessment Across the Lifespan
� � Structure and Function Subjective Data—Health History Questions Objective Data—The Physical Exam Abnormal Findings Slide 21 -2
Structure and Function � Surface landmarks � Borders of abdominal cavity � Abdominal muscles � Internal anatomy (viscera) � Solid viscera Liver Pancreas Spleen Adrenal glands Kidneys Ovaries Uterus Slide 21 -3
Structure and Function (cont. ) � Internal anatomy (viscera) (cont. ) � Hollow viscera Stomach Gallbladder Small intestine Colon Bladder Slide 21 -4
Internal Anatomy © Pat Thomas, 2006. Slide 21 -5
Deep Internal Anatomy © Pat Thomas, 2006. Slide 21 -6
Structure and Function (cont. ) � Abdominal wall divided into four quadrants � Right upper (RUQ) � Left upper (LUQ) � Right lower (RLQ) � Left lower (LLQ) Slide 21 -7
Quadrants Slide 21 -8
Subjective Data— Health History Questions � � � � � Appetite Dysphagia Food intolerance Abdominal pain Nausea/vomiting Bowel habits Abdominal history Medications Nutritional assessment Slide 21 -9
Objective Data—The Physical Exam � Preparation � Lighting and draping � Measures to enhance abdominal wall relaxation � Equipment needed � Stethoscope � Small centimeter ruler � Skin-marking pen � Alcohol swab Slide 21 -10
Objective Data—The Physical Exam (cont. ) Inspect the abdomen � Contour � Symmetry � Umbilicus � Skin � Pulsation or movement � Hair distribution � Demeanor Slide 21 -11
Contour Slide 21 -12
Objective Data—The Physical Exam (cont. ) 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
Objective Data—The Physical Exam (cont. ) Palpate the liver Measures to enhance muscle relaxation Light palpation Deep palpation Bimanual palpation Normally palpable structures Liver Spleen Kidneys Aorta Usual technique Hooking technique Slide 21 -14
Special Procedures for Advanced Practice � Rebound tenderness (Blumberg’s sign) � Inspiratory arrest (Murphy’s sign) � Iliopsoas muscle test � Obturator test Slide 21 -15
Normally Palpable Structures Slide 21 -16
Sample Charting Slide 21 -17
Sample Charting (cont. ) Slide 21 -18
Abnormal Findings Abdominal Distention � � � � Obesity Air or gas Ascites Ovarian cyst Pregnancy Feces Tumor Slide 21 -19
Abnormal Findings Abnormalities on Inspection � � Umbilical hernia Epigastric hernia Incisional hernia Diastasis recti Slide 21 -20
Abnormal Findings Abnormal Bowel Sounds � � Hypoactive bowel sounds Hyperactive bowel sounds Slide 21 -21
Abnormal Findings Abnormalities on Palpation of Enlarged Organs � � � Enlarged liver Enlarged nodular liver Enlarged gallbladder Enlarged spleen Enlarged kidney Aortic aneurysm Slide 21 -22
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