NATS 1540 Lecture Notes - Lecture 58: Ascites, Palpation, Abdominal Pain
31 May 2020
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In supine position the ascitic fluid settles into the flanks, displacing the air filled bowel upwards. You will hear tympanic notes are you percuss over the top of the abdomen because gas filled intestines float over the fluid. Shifting level of dullness: indicates the presence of fluids. Light palpation: purpose is to not search for organs but to form an overall impression of the skin surface and superficial musculature. This method avoids pain and resulting muscle rigidity that would occur with deep palpation. Voluntary guarding: occurs when the person is cold, tense, or ticklish. It is bilateral and you will feel the muscle relax slightly during exhalation. Try to relax the muscle to eliminate the guarding, if it persists it is likely. Deep palpation: purpose is to palpate the palpable organs and to detect the presence of any abnormal enlargements, tenderness or masses. Tenderness occurs with local inflammation, inflammation of peritoneum or underlying organ and with enlarged organs.
