EXAMINATION OF ABDOMEN Angela Mwaba Chipepo Chewe Nayame

EXAMINATION OF ABDOMEN • Angela Mwaba Chipepo • Chewe Nayame • Mutinta Kasaro

INTRODUCTION • The client should be in supine on the examination couch. • Abdomen exposed from the nipple line to the pubis and the drape covering the leg. • The examiner stands on the client’s right hand

INSPECTION • Inspect the abdomen for skin integrity, colour, intact or not, shiny, smooth and observe for scares. • Note the shape position and colour of the umbilicus and hernia.

INSPECTION CONT. . • Note scares, petechiae and dilated veins around the umbilicus (caput medusa) are indicative of cirrhosis. • • Silver or striae or stretch marks over the lower abdomen are often seen in women who have borne children.

INSPECTION CONT. . • Observe any movements associated with respiration, peristalsis or aortic pulsations

AUSCULTATION • Auscultate the abdomen for bowel sounds, vascular sounds and any peritoneal friction rubs using the diaphragm. • Normal bowel sounds occur irregularly at a rate of 5 -35 per minute.

ABNORMAL FINDINGS • Absence of bowel sounds indicates paralytic ileums. • Bruits which may indicate vascular disease. (Except for thin young clients) • Friction rub sounds suggest hepatic tumour. When heard loudest over the lower right rib cage or it may indicate splenic inflammation when heard loudest over the lower rib cage, in the anterior axilla line.

PERCUSSION • It is used to detect the presence of fluid, gaseous distension and solid masses and to determine the size and location of abdominal organs. • Percuss the abdomen for tympany (high pitched, loud or musical) which are due to gas and fluid in the stomach, bowel and colon.

PERCUSSION CONT. . • Percuss the abdomen to determine liver and spleen size • Dull (Thud-like) sounds are heard over fluid and solid organs. • Percuss the abdomen to define the outline of a distended bladder

PERCUSSION CONT. . • Do not Percuss the abdomen if you suspect an abdominal aneurysm or if the client has under gone abdominal organ transplantation.

PALPATION • Light palpation is used to detect masses, areas of muscular spasms or rigidity, area of direct tenderness. • Deep palpation is used to determine the size and shape of abdominal organs and masses. •

PALPATION CONT. . • Palpate the liver, spleen and kidneys to determine position and size • Palpate the abdomen to detect tenderness, presence of masses and distension

Inguinal Region • Palpate for inguinal lymph nodes, pulses and to detect any hernias