NSE 13A/B Lecture Notes - Lecture 6: Abdominal Examination, Abdominal Pain, Hematemesis
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Solid viscera: liver, pancreas, spleen, kidneys, adrenal glands, ovaries, and uterus. Hollow viscera: stomach, gallbladder, small intestine, colon, and bladder. Bowel habits: melena: blood in stool. Ask about painful areas (assess those areas last) Supine position with head on pillow, hands at side and knees bent. Rounded: abdomen rounds up, higher than ribs. Protuberant: round, protruding abdomen, e. g. pregnancy or toddler. Texture, scars, colour, lesions, dilated veins, rash & striae (stretch marks) Begin at right lower quadrant (rlq) at ileocecal valve. Expected findings: high pitched gurgling sounds with normal frequency heard in all four quadrants. What should you do if you hear a bruit: percussion. Air rises to the surface while in supine position. Note any findings of dullness (muddled thud) distended bladder, adipose tissue, masses. Note findings of hyperresonance (booming, lower pitch sound than resonance) Note the location of when the sound magnifies. Overall impression of skin surface and superficial musculature.
