EXAMINATION of the ABDOMEN

CORRECT ORDER INSPECTION: What are you looking for? Contour flat, rounded, protuberant, scaphoid Symmetry bulges, pulsations, umbilicus Skin color, hair, striae, scars AUSCULTATION: What are you listening for? Bowel diaphragm, hyper/hypoactive, absent Vascular bell, bruits PERCUSSION: What are you listening for? Tympany Liver 6-12cm Spleen Masses/Fluid PALPATION: Skin turgor, temp Light surface evaluation, technique Deep organ evaluation, technique Liver 2 techniques Spleen nonpalpable Kidneys usually not palpable Aorta aneurysm

PERIPHERAL VASCULAR/LYMPHATICS
ARMS: Inspect Size, symmetry, swelling Skin color, texture, nail beds, clubbing Palpate: Skin Texture, temperature Edema (grade 0 to 4+), capillary refill (symmetry) Pulses: brachial, radial, ulnar, grade 0 to 4+ Nodes epitrochlear (nonpalp) LEGS: Inspect: Size, symmetry, swelling Skin color, Texture, Nail beds, Hair distribution, clubbing Venous pattern (standing) Palpate: Skin Texture, temperature Edema (grade 0 to 4+), capillary refill (symmetry) Nodes: Inguinal Pulses: femoral, popliteal, dorsalis pedis, posterior tibial Homans sign Professionalism/confidence: