Summary
Summary Physical Exam Abdomen for Clinical Skills Exam
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This gives an overview of the Physical Examination of the Abdomen, Andrology & Urology, Gynaecology & The Breast Examination.
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Examination AbdomenOrder of Exam:
1. General impression & general exam
2. Inspection
a. at rest
3. Auscultation
4. Percussion
a. General
b. Topographic
5. Palpation
a. Superficial palpation
b. Deep palpation (bimanual)
i. General
ii. Topographic
6. Special tests
General impressions Exam:
• ill not ill?
• Colour of f ace -> Pallor (conjunctiva), blue (oral mucosa & tongue), yellow/jaundice (skin, sclerae & oral
mucosa)
• Post ure -> bent forward? Laying motionless? drawn up knees? -> indications of pain
• Vit al signs --> ABCDE -> treat what kills first
• Te mpe rat ure -> fever ≥ 38˚C &Hypothermia: <35 ˚C
• Blood pre ssure -> BP > 140/90 is too high + Systolic BP < 90mmHg too low
• Pulse -> radial artery (acute situations,= -> carotid/femoral)
• normal for children & adults at rest -> 60-100/min
• Re spirat ory rat e
• normal value -> 14-20/min
• Capillary re f ill -> of extremity and/or Sternum (acute)
• CR extremity < 5sec & CR sternum <2 sec
JALCCOD -> jaundice, anaemia, lymphadenopathy, cyanosis, clubbing, oedema, dehydration
Inspection (at rest)
• Abdominal skin
• surgical scars
• flat or protruding umbilicus -> increased abdominal pressure -> ascites, tumour, pregnancy
• dilated veins -> around umbilicus -> caput medusa -> portal hypertension
• Symme t ry -> dif f use & local
• Diffuse -> gas in intestines, severe constipation, ascites, tumour (overfilled ladder -> lower abdomen)
• Local -> strongly enlarged abdominal organs (liver, spleen, kidney, abdominal tumour) OR Abdominal
hernia
• Abdominal move me nt s:
• Respiratory movement -> abdominal or chest respiration
• superficial, partial or absent respiration -> peritoneal irritation
• only chest respiration -> no movement of abdominal wall -> generalised peritonitis
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