Abdominal Exam

Patient down to underwear

General Inspection -> abdominal scars, catheter bag, drains, stoma sites, IV drips, distended abdomen, nutritional feeds

Inspect hands -> clubbing, leuchonychia, koilonychia, palmar erythema, duputrens contracture.

Asterixis flap

Radial Pulse

Offer BP

Eyes-> jaundice, anaemia, kayser fleischer rings, xanthelasma

Face- spider naevi

Mouth- ulcers, angular stomatis, telangiectasia, candidiasis, peutz-jehger spots, glossitis, dentition

Neck -> JVP, left supraclavicular virchows node torissiers sign

Chest-> gynaecomastia, spider naevi, ascites, cullens sign, grey turners sign. obvious peristalsis

Bed is flat !

Ligh then deep palpation all 9 areas- masses, guarding, rebound tenderness

Palpate liver whilst they breathe out

Palpate to spleen when they breathe out

Palpate supra pubic region - urinary retention

Palpate aorta- expanile

Palpate hernias whilst they cough

Ballot Kidneys

Percuss to liver

Percuss to spleen

Percuss for ascites -> shifting dullness, fluid thrill (for this you stand up)

Auscultates bowel sounds and renal bruits

Examines legs for skin lesions - erythema nodosum

Also do DRE, exam of external genitalia, inspect observation charts , urine dip

- Peritonitis

- Appendicits

- Paralytic ileus

- Bowel obstruction

- Liver cirrhosis

- Iron deficiency

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