OPETA: Abdomen

Abdomen	Online PETA Home
View Entire Video Primary Exam General Inspection Auscultation Auscultation for Bruits Percussion Light Palpation Deep Palpation Liver and Aorta Palpation of the Spleen Special Considerations Be able to identify the significance of a positive finding of any of these tests Rebound Tenderness Liver Scratch Test Costovertebral Tenderness Shifting Dullness Leg Signs for Appendicitis	General Position patient and drape Use the correct terminology for locations on the abdomen Ask patient to point to areas of pain and examine that area last Inspection Look for scars, striae, hernias, vascular changes, lesions, or rashes Look for pulsations or peristalsis Observe the abdominal contour Auscultation Listen until bowel sounds are heard or for a full minute Report sounds as increased, decreased, or normal Auscultation for Bruits Auscultate for aorta Auscultate for renal arteries Auscultate for iliac arteries Percussion Percuss in all 4 quadrants Outline areas of dullness and tympany Percuss liver span in midclavicular line Percuss for splenic dullness at the last interspace in the left anterior axillary line Light Palpation Lightly palpate in all 4 quadrants and the midline Observe for signs of discomfort Deep Palpation Deeply palpate in all 4 quadrants and the midline Identify organ enlargement or other masses if present Liver and Aorta Palpate for the liver Palpate for the aorta and determines width Palpation of the Spleen Position yourself on patient's right Lift patient's left flank Palpate at left costal margin Ask patient to take a deep breath Finish palpation Special Considerations: Rebound Tenderness Warn patient Slowly press abdomen on the side of reported pain Quickly release pressure Observe for signs of discomfort Special Considerations: Liver Scratch Test Place diaphragm of stethoscope over upper margin of liver Lightly scratch the skin below the anticipated lower edge of the liver Methodically scratch higher until sound is magnified by the mass of the liver Special Considerations: Costovertebral Tenderness Warn patient Place hand over CV angle Hit smartly with other hand Observe for signs of discomfort Repeat on other side Special Considerations: Shifting Dullness Percuss level of dullness Ask patient to roll on side Percuss new level of dullness Repeat on other side Special Considerations: Leg Signs for Appendicitis Ask patient to raise right leg against resistance (Psoas Sign) Raise and internally rotate right leg with knee flexed (Obturator Sign)
ONLINE PHYSICAL EXAM TEACHING ASSISTANT	The UF College of Medicine Harrell Center