Health Assessment Across the Lifespan

Structure and Function Subjective Data—Health History

Questions Objective Data—The Physical Exam Abnormal Findings

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Surface landmarks Borders of abdominal cavity Abdominal muscles

Internal anatomy (viscera) Solid viscera

Liver Pancreas Spleen Adrenal glands Kidneys Ovaries Uterus

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Internal anatomy (viscera) (cont.) Hollow viscera

Stomach Gallbladder Small intestine Colon Bladder

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© Pat Thomas, 2006.

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© Pat Thomas, 2006.

Abdominal wall divided into four quadrants Right upper (RUQ) Left upper (LUQ) Right lower (RLQ) Left lower (LLQ)

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Appetite Dysphagia Food intolerance Abdominal pain Nausea/vomiting Bowel habits Abdominal history Medications Nutritional assessment

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Preparation Lighting and draping Measures to enhance abdominal wall

relaxation

Equipment needed Stethoscope Small centimeter ruler Skin-marking pen Alcohol swab

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Inspect the abdomen Contour Symmetry Umbilicus Skin Pulsation or movement Hair distribution Demeanor

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Auscultate the abdomen

Bowel sounds Vascular sounds

(bruits)

Percuss the abdomen General tympany Liver span

Usual technique Scratch test

Splenic dullness Costovertebral

angletenderness

Special procedures Fluid wave Shifting dullness

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Palpate the liver Measures to enhance

muscle relaxation Light palpation Deep palpation Bimanual palpation Normally palpable

structures Liver

Usual technique Hooking technique

Spleen Kidneys Aorta

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Rebound tenderness (Blumberg’s sign) Inspiratory arrest (Murphy’s sign) Iliopsoas muscle test Obturator test

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Obesity Air or gas Ascites Ovarian cyst Pregnancy Feces Tumor

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Umbilical hernia Epigastric hernia Incisional hernia Diastasis recti

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Hypoactive bowel sounds Hyperactive bowel sounds

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Enlarged liver Enlarged nodular liver Enlarged gallbladder Enlarged spleen Enlarged kidney Aortic aneurysm

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