Skip to main content
danger

This article is automatically translated and has not yet been reviewed by an expert!

Abdominal Physical Examination

Pre-examination​

  • Check if the hand sanitizer is within its expiration date.
  • Verify the patient's information.
  • Introduction:

    Greetings, I am your attending physician. Due to the needs of your condition, we need to perform an abdominal physical examination.

Inspection​

  • Patient on their right side.
  • Examine the abdomen at eye level.

    The examinee primarily breathes abdominally. The abdomen is flat, with no visible rashes, ulcers, pigmentation, surgical scars, etc., no varicose veins, gastric or intestinal patterns, peristaltic waves, etc., and no hernias or striae.

Auscultation​

  • Bowel sounds: Place the stethoscope on the abdomen. Time for 1 minute, 4 sounds per minute.
  • Arterial auscultation:

    • Abdominal aorta: Midpoint of the line between the umbilicus and xiphoid process.

    • Renal arteries: At the intersection of the midline of the line between the umbilicus and xiphoid process and the lateral border of the rectus abdominis muscle on both sides of the upper abdomen.

    • Iliac arteries: At the intersection of the lateral border of the rectus abdominis muscle and 2 cm above the midpoint of the line between the umbilicus and pubic symphysis on both sides of the lower abdomen.

    • Scratching sounds: Place the stethoscope on the examiner’s side and scratch toward the stethoscope position.

Percussion​

  • Start from the left lower quadrant (away from the examiner), percuss counterclockwise (initially upwards) towards the umbilical region. Report tympany.
  • Liver boundary percussion:
    • Begin at the right costal margin, reaching the fifth intercostal space along the right midclavicular line, where clear sounds change to dull.
    • Begin at the right side of the abdomen, reaching the point where the umbilicus intersects the right costal margin, where tympanic sounds change to dull.
  • Percussion for shifting dullness (positive sign):
    • Start at the umbilical level, percussing from the center to the left, tympany changes to dullness; after turning onto the right side, the original point changes from dull to tympanic.
    • Repercuss, percuss directly to the right, dullness changes to tympany; after turning onto the left side, the original point changes from dull to tympanic.
  • Bladder percussion: Below the umbilical midline, from tympany to dullness.

Palpation​