Inspection, Auscultation, Percussion, and Palpation of the abdomen (in that order) for diagnostic findings and discovering underlying pathology
Assessment
- Health History of abdominal disease, bowel patterns and characteristics (frequency, consistency, color, flatulence, belching), problems with weight loss or gain, food habits (appetite, taste, intolerance, N&V, hematemesis, odynophagia, dysphagia)
- Medical History: surgeries, medications, etc.
- Laboratory Results
- Family History of abdominal disease.
Subdivisions of the Abdomen
- Quadrants
- RU: mainly the liver and gallbladder; head of pancreas
- LU: the stomach, spleen, left lobe of liver, and body of pancreas.
- RL: cecum, appendix, ureter, spermatic cord, ovary
- LL: descending colon, sigmoid colon, ureter, spermatic cord, ovary
- Nine regions
Test for Appendicitis
- Blumber’s Sign: a sharp-stabbing pain as pressure is released from the abdomen (rebound tenderness).
- Rovsing’s Sign: pain in the LRQ from pressure applied in the LLQ.
- Psoas Sign: pain in the RLQ when raising the right leg from the hip while applying pressure on the lower thigh.
- Obturator Sign: pain in the RLQ when then hip and knee are flexed, and rotated internally.
Murphy’s Sign
Used for patients with inflammation of the gallbladder (cholecystitis)
- Hold the fingers under the liver border, and ask the patient to take a deep breath.
- If the patient abruptly stops midway and experiences pain, then the sign is positive.