PEMERIKSAAN

REGIO ABDOMEN
 Common or Concerning Symptoms
Gastrointestinal Disorders
• Indigestion or anorexia
• Nausea, vomiting, or hematemesis
• Abdominal pain
• Dysphagia and/or odynophagia
• Change in bowel function
• Constipation or diarrhea
• Jaundice
Urinary and Renal Disorders
• Suprapubic pain
• Dysuria, urgency, or frequency
• Hesitancy, decreased stream in males
• Polyuria or nocturia
• Urinary incontinence
• Hematuria
• Kidney or flank pain
• Ureteral colic
 Xiphoid
process

Liver
Aorta

Lower pole of
Right kidney Transverse colon
Ascending colon
Descending and
Cecum Sigmoid colon
Sacral Iliac artery
promontory
Pregnant
uterus Full bladder
 Xiphoid process
Rectus abdominis
muscle

Costal margin

Midline, overlying
Linea alba
Umbilicus Iliac crest
Anterior superior
Iliac spine

Inguinal ligament

Pubic tubercle Symphysis pubis

TOPOGRAFI
TOPOGRAFI
 Spleen
Liver

Gallbladder Stomach
Pancreas
Duodenum

ANTERIOR VIEW
 Costovertebral
angel

11th rib

12th rib

Kidney

POSTERIOR VIEW
 Epigastric pain from
the stomach, duodenum
Right upper quadrant or pancreas
or epigastric pain from
the biliary tree and liver
Periumbilical pain from
the small intestine,
appendix, or proximal
colon

Hypogastric pain from

the colon, bladder, or
Suprapubic or sacral uterus. Colonic pain
pain from the rectum may be more diffuse
than illustrated.
Aorta

Renal Artery

Iliac Artery

Femoral Artery
TWO-HANDED DEEP PALPATION
PERKUSI LIVER NORMAL LIVER SPANS
PERCUSSING LIVER SPAN
 4 – 8 cm in
midsternal line

6 – 12 cm in right
midclavicular line

NORMAL LIVER SPANS

PALPASI LIVER
SPLENOMEGALI
 Anterior
axillary line
Midaxillary line

Normal spleen
Percuss here
Anterior
axillary line
Midaxillary line
Inspiratory
movement

NEGATIVE SPLENIC PERCUSSION SIGN

POSITIVE SPLENIC
PERCUSSION SIGN
PALPASI SPLEEN
 Umbilicus

PALPATING THE SPLEEN-PATIENT LYING ON RIGHT SIDE

 Splenomegali
• Diukur dengan garis Schuffner
• Dari lengkung iga kiri, umbilikus, SIAS
• Dibagi menjadi 8 bagian sama
• Perhatikan insisura lienalis
Assessment Techniques for :

• Ascites
• Appendicitis
• Acute cholecystitis
• Ventral hernia
• Mass in abdominal wall
 Pemeriksaan ascites
• Fluid wave
• Shifting dullness
• Puddle sign
Pemeriksaan cairan
ascites
(Shifting dullness)
Tympany

Dullness
Tympany

Dullness
Pemeriksaan cairan ascites
(test of fluid wave)
 Kandung empedu
• Murphy’s sign pada kolesistitis
• Courvoisier’s law, jaundice, teraba kandung
empedu biasanya karena terdapat obstruksi
bilier karena karsinoma kaput pankreas
Umbilical Hernia Incisional Hernia Epigastric Hernia

INFANT
Diastasis Recti Lipoma
Ridge
Fat Gas

Tumor

Tympany

Dullness
Pregnancy Ascitic Fluid

Tympany
Tympany
Dullness

Dullness

Ascitic Fluid

Tympany

Dullness

Umbilicus may be
Bulging protuberant
flank
Bowel Sounds Bruits

Renal artery
Aorta
Iliac Artery
Venous Hum

Epigastric and
umbilical

Friction Rubs

Hepatic
Splenic
Abdominal Wall Tenderness

Superficial tender area

Deep tender areas

Visceral Tenderness

Enlarged liver
Normal aorta

Normal cecum Normal or spastic

sigmoid colon
Tenderness from Disease in the Chest and Pelvis

Unilateral or
bilateral, upper or
lower abdomen

Acute Pleurisy Acute Salpingitis

 Tenderness of Peritoneal Inflammation

Acute Cholecystitis Acute Pancreatitis

 Tenderness of Peritoneal Inflammation

Just below the

middle of a line Acute Diverticulitis
joining the
umbilicus and the
anterior superior
iliac spine

Right rectal
tenderness

Acute Apendicitis
 Downward Displacement of
the Liver by a Low Diaphragm

Upper
border low
Height by
Percussion
normal Normal Variations in
Liver Shape

Elongated
right lobe
 Smooth Large Nontender Liver

Smooth Large Tender Liver Large Irregular Liver

Caput Medusae
Hernia Umbilicalis
 PEMERIKSAAN
GINJAL & SAL.KENCING
Palpasi Ginjal
ASSESSING COSTOVERTEBRAL ANGLE TENDERNESS
Kidney Tenderness
 PEMERIKSAAN
ANGGOTA GERAK
Pemeriksaan lengan, tungkai dalam
pemeriksaan klinis meliputi :

1. Inspeksi
2. Palpasi
3. Menguji pergerakan dan kekuatan otot
4. Menguji gerakan koordinasi
5. Menguji sensibilitas
6. Memeriksa reflek- reflek
Cellulitis
Gangrene
Venous Insufficiency
 Tes Koordinasi

Tes koordinasi jari telunjuk ke hidung

Hip pain
Laseque Test
Neural damage

Non neural damage

Tes Lasseque
Biceps

Triceps

Tes Refleks