Gastrointestinal Exam

Introduction Hell my name is… Explanation of what you want to do Patient position – supine at 45° Any pain??

End of the bed General appearance Oxygen, drips, catheters, medications, drains Nutritional status / cachexia

Hands and nails Tendon xanthoma Dupuytren’s contracture Palmar erythema Clubbing Leuconychia Koilonychia Flapping tremor Bruising IVDU marks

Face Moon face Plethora Acne Hirsute Parotid enlargement Scleral icterus Corneal arcus Xanthelasma Episcleritis / conjunctivitis Conjunctival pallor Angular stomatits Oral candidisis Neck lymph nodes

Chest and back Gynaecomastia Loss of secondary sexual hair Spider naevi

Inspection Abdominal distension Caput medusa Scars

Palpation (and a little percussion) Light and deep Liver Spleen Kidneys AAA Percus for shifting dullness

Auscultation Bowel sounds Renal bruits

Legs Peripheral oedema Pyoderma gangrenosum Erythema nodosum

Conclusion Allow the patient to re-dress Wash hands Summaries your findings “To complete this examination I would also like to examine the patients groins, genitalia and perform a PR”