Term
| Inspection skin and surface of the abdomen |
|
Definition
Scars (post surgical, posttraumatic, postherpetic), Striae (stretch marks, pregnancy, Cushings, ascites, wasting, dieting)
Superficial veins: Look for prominent superficial veins, which may be apparent in three situations: thin veins over the costal margin,
usually of no significance; occlusion of the
inferior vena cava; and venous anastomoses in
portal hypertension(caput medusae).
Stomas: Stomas are surgically created openings
in the abdominal wall and are identified by the
presence of a stoma bag overlying these.
Pigmentation: Midline below the
umbilicus: linea nigra sign of pregnancy.
Erythema ab igne is a brown
mottled pigmentation produced by constant
application of heat, usually a hot water bottle or
heat pad. It is a sign that the patient is experiencing
severe persistent pain, such as from chronic
pancreatitis. |
|
|
Term
| The location of abdominal pain is |
|
Definition
|
|
Term
|
Definition
an involuntary reflex contraction of the
muscles of the abdominal wall overlying an inflamed viscus and peritoneum, producing localized rigidity.
It indicates localized peritonitis. Guarding is seen
classically in uncomplicated acute appendicitis. |
|
|
Term
| Generalized or ‘board-like’ rigidity |
|
Definition
|
|
Term
|
Definition
is present if, when palpating
slowly and deeply over a viscus and then suddenly
releasing the palpating hand, the patient experiences
sudden pain. |
|
|
Term
| Framework for the abdominal examination |
|
Definition
General inspection
• The hands
• The arms
• The axillae
• The face
• The chest
• Inspection of the abdomen
• Palpation of the abdomen
• Light
• Deep
• Specific organs
• Examination of the hernial orifices
• External genitalia.
• Percussion (± examination of ascites)
• Auscultation
• Digital examination of the anus, rectum ± prostate. |
|
|
Term
|
Definition
Cullen’s sign: discoloration at the umbilicus and surrounding skin.
• Grey Turner’s sign: discoloration at the flanks.
Both Seen in Pancreatitis |
|
|
Term
| Watch the patient’s face for |
|
Definition
|
|
Term
| Position of the patient before abdominal examination |
|
Definition
The patient should be positioned lying supine with the head supported by a
single pillow and arms at their sides. |
|
|
Term
| Before you palpate the liver and spleen what should you ask the patient to do? |
|
Definition
|
|
Term
| If a liver edge is felt, you should note: |
|
Definition
• How far below the costal margin it extends in finger-breadths or
(preferably) centimetres and record the number carefully.
• The nature of the liver edge (is the surface smooth or irregular?).
• The presence of tenderness.
• Whether the liver is pulsatile. |
|
|
Term
|
Definition
A sign of cholecystitis—pain on palpation over the gallbladder during
deep inspiration. Only positive if there is NO pain on the left at the same
position. |
|
|
Term
|
Definition
| Use the back of your hand to compare abdominal skin temperature with the thighs. |
|
|
Term
| Purpose of Deep Palpation: |
|
Definition
• Apply more pressure to detect:
o Masses
o Organ enlargement
o Tenderness deep in the abdomen |
|
|
Term
|
Definition
| Palpate in the midline above the umbilicus for a pulsatile mass. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
if gross ascites suspected Ask patient to place the edge of their hand along the midline (to stop transmission).
• Tap one flank and feel on the opposite side for a transmitted wave. |
|
|
Term
| Additional Examinations to Complete g.i. Station |
|
Definition
“To complete the examination, I would also like to:”
• Check for hernias: inguinal, femoral, and umbilical orifices.
• Inspect the external genitalia (if appropriate).
• Examine lower limbs for oedema (suggests hypoalbuminaemia or portal hypertension).
• Perform a digital rectal examination (if indicated by symptoms). |
|
|
