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Abdominal examination

Abdominal examination and diagnostics, which summarizes the body surface signs and divisions of the abdomen, visual inspection, auscultation, percussion, palpation, common abdominal diseases, etc.

Edited at 2024-01-20 23:50:34

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Abdominal examination

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Outline

Abdominal examination

Body surface markings and divisions of the abdomen

body surface markers

lower edge of rib

xiphoid process

upper abdominal corner

navel

anterior superior iliac spine

outer edge of rectus abdominis

ventral midline

inguinal ligament

pubic symphysis

costovertebral angle

abdominal zoning

four division method

right upper abdominal area

right lower abdominal area

left upper abdominal area

left lower abdominal area

nine division method

Right upper abdomen (right rib)

Right side of abdomen (right waist)

Right lower abdomen (right iliac region)

upper abdomen

Mid-abdomen (umbilicus)

Lower abdomen (upper pubic area)

Left upper abdomen (left rib)

Left side of abdomen (left waist)

Left lower abdomen (left iliac region)

Inspection

abdominal shape

Abdominal distension

Total abdominal distension

Ascites

abdominal gas

huge intra-abdominal mass

local swelling

sunken abdomen

Full abdominal depression

local depression

respiratory movement

abdominal breathing

chest breathing

abdominal wall vein

portal hypertension

inferior vena cava obstruction

superior vena cava obstruction

Gastrointestinal and peristaltic waves

Other conditions of the abdominal wall

rash

pigment

Abdominal lines

scar

hernia

abdomen

abdominal body hair

Upper abdominal pulsation

auscultation

Normal bowel sounds (4 to 5 times)

Hyperactive bowel sounds

Diminished bowel sounds

vascular murmur

fricative sound

Scratch test

percussion

Abdominal percussion sounds

Liver and gallbladder percussion

Hepatic relative dullness boundary (superior liver boundary)

Hepatic absolute dullness boundary (inferior hepatic boundary)

Normal upper and lower boundaries of liver

On the right midclavicular line, the upper limit of the liver is at the fifth intercostal space, and the lower limit is at the lower edge of the right third rib.

On the right midaxillary line, the upper limit of the liver is at the 7th intercostal space, and the lower limit is at the level of the 10th rib.

On the right scapular line, the upper limit of the liver is the 10th intercostal space

Percussion pain in gallbladder area

Gastric tympanic area and spleen percussion

mobile voicedness

When the free intra-abdominal fluid is more than 1000ml, a moving murmur can be detected

Easily misdiagnosed as abdominal effusion

intestinal obstruction

giant ovarian cyst

Percussion pain at costovertebral angle

Bladder percussion

palpation

Abdominal wall tension

Increased abdominal wall tension

Reduced abdominal wall tone

Tenderness and rebound tenderness

gallbladder tenderness points

Max point

Rovshin Zheng

psoas sign

rebound tenderness

Indicates that intra-abdominal organ lesions involve nearby peritoneum

Peritoneal irritation (triad of peritonitis)

Tense abdominal muscles

tenderness

rebound tenderness

Palpation of organs

Liver palpation

Palpation method

One-handed palpation

bimanual palpation

hook finger palpation

Palpation content

size

texture

Edge and surface conditions

tenderness

pulsating

Friction in liver area

Liver tremors

Palpation of spleen

How to measure splenomegaly

Line Ⅰ measurement: the distance from the intersection of the left midclavicular line and the costal margin to the lower edge of the spleen

Line II measurement: the distance from the intersection of the left midclavicular line and the costal margin to the farthest point of the spleen

Line III measurement: the distance between the posterior edge of the spleen and the anterior midline

Gallbladder palpation

Murphy's sign

levy of couisier

Kidney palpation

Bladder palpation

Palpation of the pancreas

abdominal mass

Normal abdominal palpable structures

Rectus abdominis muscle belly and tendon

Lumbar vertebrae and sacral promontory

sigmoid colon feces mass

transverse colon

Cecum

abnormal lump

parts

size

form

texture

tenderness

pulsating

Mobility

liquid wave tremor

It requires more than 3000~4000ml liquid volume to detect

Zhenshuiyin

Common abdominal diseases

peptic ulcer

gastric ulcer

duodenal ulcer

acute peritonitis

Cirrhosis

acute appendicitis

intestinal obstruction

mechanical intestinal obstruction

dynamic intestinal obstruction

vascular intestinal obstruction

abdominal mass

inflammatory

neoplastic

Obstructive

congenital

parasitic

other