1. Assessment of the Abdomen
By Freida Fuller-Jonap
fulerjonap_f

2. The Abdominal Assessment Includes
the lower end of the esophagus
stomach
kidneys
edge of the urinary bladder
spleen
liver
gallbladder
uterus
large and small intestines
peritoneum

3. Health History Data Should Include
possibility of pregnancy
family history
previous GI or GU trauma
specific problems related to GI tract and GU system
Diet nutrition
level of stress
alcohol/cigarette smoking
medications
stood
urinary
exposure to infectious disease

5. Assessment should occur in a particular order
Inspection
Ausculatation
Percussion
Palpation

6. Inspection
Skin: color, texture, scars, lesions, striae, rashes, wounds, incisions, ostomies, etc
Color:
Grey Turner Sign
jaundice
ascites

7. Contour: flat, rounded, concave, protuberant Assymetry Masses Movement
Vascularity
Striae
Inspect the Umbilicus
Cullen’s sign
Contour: flat, rounded, concave, protuberant
Assymetry
Masses
Movement

8. Pulsations of the aorta
Peristalsis of intestines

9. Auscultation
Bowel sounds
hyperactive
hypoactive
Absent

10. Vascular Sounds Friction Rubs Bruits aorta renal arteries
iliac arteries
Friction Rubs

12. Percussion Tympany Liver Span: normal span 6-12 cm.
Liver enlargement, hepatomegaly is characterist of liver tumors, cirrhosis, abscess, and vascular engorgement
Fist Percussion of CVA

13. Palpation Light palpation Deep palpation Palpation of the Liver
Palpation of the spleen
Palpating kidneys
Palpating the urinary bladder

14. Special Abdominal Tests
Ascites
Fluid Wave
Fluid Shift

16. Special Abdominal Tests (continued)
Ballottement Technique
Appendicitis
Rebound tenderness (Blumberg’s sign
Rovsing’s
Referred rebound tenderness

17. Psoas
Oburator sign
Acute cholecystitis
Murphy’s sign

18. Diagnostic Testing
Ultrasound of the Abdomen: visualize abdominal aorta, liver, gallbladder, pancreas, bile ducts, spleen kidneys, ureters, and bladder
CT of the Abdomen
MRI: less accurate that CT for most abdominal diseases, maybe better for liver and pelvis that CT

19. Tests for Gallbladder Diseases
Bilirubin
Direct
Indirect

20. Diagnostic Study for the Pancreas
Serum Amylase

21. Liver Studies Ammonia: hepatitis, cirrhosis, hepatic encephalopathy
Prothrombin Time: cirrhosis, hepatitis, bile duct obstruction,
ALT (alanine aminotransferase: hepatitis, liver necrosis, cirrhosis, cholestasis, tumor and hepatotoxic drugs

22. AST (aspartate aminotransferase) Used to be SGOT
AST (aspartate aminotransferase) Used to be SGOT. Hepatitis, gallstone, cirrhosis
AST/ALT ratio: cirrhosis, liver congestion, tumors
ALP (alkaline phosphatase): cirrhosis, biliary obstruction, liver tumor

23. Diagnostic Tests for Kidney Disorders
BUN: metabolic function of the liver and excretory function of the kidney
Increased: renal disease/failure, nephrotoxic drugs
GI bleeding, excessive protein ingestion
Decreased: Liver failure, overhydration, malnutrition, malabsorption, nephrotic syndrome
Creatinine
Potassium

24. IVP: intravenous pyelogram KUB: Kidneys, ureters, bladder
Urinalysis
Protein
Leukocyte esterase
Nitrates
Urine for C & S
IVP: intravenous pyelogram
KUB: Kidneys, ureters, bladder

25. Diagnostic Tests for Gastrointestinal System
EGD (esophagogastroduodenoscopy): tumors, esophageal diverticula, hiatal hernia, esophagitis, gastritis…
Barium enema
Barium Swallow
Colonoscopy
Sigmoidoscopy