Clinical Examination of Abdomen.pdf Dr. Ashok Mhaske

For UG Students
It introductory for reference

1. Date
Clinical Examination of Abdomen
Dr. Ashok Mhaske
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2. “The eyes do not see what the mind
does not know.”
–Sir William Osler
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3. Date
Anatomy
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12. Date
Examination Of Abdomen
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13. “Consent of the patient”
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14. •Sanitise your hands
•In_case of Female _Female attendant is a must
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15. •Patient should empty the bladder.
•Position - Supine with head supported on a pillow and
arms by the side
•Abdomen exposed from nipple line to mid thigh dropped
appropriately
•Examiner stands on the right side.
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16. Date
Steps of Examination
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17. Date
Inspection
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18. “Eyes don’t see what the mind does
not know.”
–Sir William osler
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19. Inspection
•Contour
•Symmetry
•Skin
•Umbilicus
•Movement with respiration
•Visible peristalsis / Pulsations
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29. Date
Palpation
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30. Palpation
•Always use warm hands and begin gently
•Start from an area away from pain or tenderness.
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31. Superficial Palpation
•Detect tenderness, guarding or rigidity
•Assess for superficial masses
•Look for rebound tenderness ( Blumberg’s Sign)
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32. Deep Palpation
•For deeper structures and organ borders
•Proceed systematically from right iliac fossa upwards
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33. •Liver
•Spleen
•Kidney
•Bladder
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37. Date
Percussion
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38. Percussion
•Helps to differentiate solid , fluid and gaseous areas
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39. •General percussion
•Liver span
•Spleen
•Traube’s Space
•Ascites
•Shifting Dullness
•Fluid Thrill
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40. •Succussion splash-
•intra abdominal viscus distended with fluid and gas-
•usually the stomach
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41. •Percussion causes pain if peritonitis is present
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42. Date
Auscultation
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43. •Bowel Sounds
•Vascular bruits
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44. •A vascular bruit, or vascular murmur, is an abnormal
"whooshing" sound heard with a stethoscope over a
blood vessel.
•Sound indicates turbulent, or choppy, blood flow,
•Typically caused by a partial obstruction or a localized
high rate of blood flow in an artery. 
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45. Auscultation
•Peristalsis produces gurgling sound because bowel
contains a mixture of fluid and gas
•Normal bowel sound are low pitched gurgles and
occurs every few seconds
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46. •Absent indicates that peristalsis has ceased.
•No bowel sounds over 30 seconds
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47. •Intestinal obstruction - Bowel distension and increased
frequency of Bowel sounds
•Amphoric in nature with high frequency
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48. Special Tests
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49. Rectal & Genital Examination
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54. Interpret Collectively
to reach a provisional
diagnosis
E.g
Lump in abdomen
Hepatomegaly
Intestinal Obstruction
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55. “In medicine , practice is not just repetition - it is
refinement.”
“Skill in examination is not inherited - it is earned
through patience, practise and perseverance.”
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56. “Listen to your patient, he is telling you the diagnosis.”
–Sir William Osler
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