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Assessment of the Abdomen

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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

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