1. Assessment of the Abdomen
Denise Coffey MSN, RN
Assessment of the Abdomen

2. Anatomy Review Surface landmarks Internal anatomy (viscera)
Borders of abdominal cavity
Abdominal muscles
Internal anatomy (viscera)
Solid viscera
Liver
Pancreas
Spleen
Adrenal glands
Kidneys
Ovaries
Uterus

3. Anatomy Review Internal anatomy (viscera) (cont.) Hollow viscera
Stomach
Gallbladder
Small intestine
Colon
Bladder

4. Anatomy Review

5. Anatomy Review

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

7. Landmarking

8. Subjective Data Appetite Dysphagia Food intolerance Abdominal pain
Nausea/vomiting
Bowel habits
Abdominal history
Medications
Nutritional assessment

9. Objective Data Inspect the abdomen Contour Symmetry Umbilicus Skin
Pulsation or movement
Hair distribution

10. Objective Data Auscultate the abdomen Bowel sounds
Vascular sounds (bruits)
Percuss the abdomen
General tympany
Liver span
Usual technique
Scratch test
Splenic dullness
Costovertebral angle tenderness
Special procedures
Fluid wave
Shifting dullness

11. Objective Data Palpate the liver Measures to enhance muscle relaxation
Light palpation
Deep palpation
Bimanual palpation
Normally palpable structures
Liver
Spleen
Kidneys
Aorta

12. Objective Data

13. Abnormalities Obesity Air or gas Ascites Ovarian cyst Pregnancy Feces
Tumor
Umbilical hernia
Epigastric hernia
Incisional hernia
Diastasis recti

14. Abnormalities Hypoactive bowel sounds Hyperactive bowel sounds
Enlarged liver
Enlarged nodular liver
Enlarged gallbladder
Enlarged spleen
Enlarged kidney
Aortic aneurysm

15. Abnormalities