Abdominal Exam AllAbdominal Jul 17 Written By Benjamin Armstrong Intro Candidate introduces self with full name and role Adheres to appropriate infection control measures Asks patient if they are in any pain prior to beginning examination Gains consent Initial Inspection Adequately exposes the patient Identifies findings around the examination space Comments on patients appearance from the end of the bed Peripheral Examination: Inspects hands, arms, and axilla e.g. palmar erythema, nail changes, needle marks, fistula, acanthosis nigricans Checks radial pulse Checks for asterixis / flapping tremor Inspects face and mouth e.g. erythema, glossitis, ulcers Inspects neck for JVP Palpates supraclavicular nodes for lymphadenopathy Inspects chest e.g. spider naevi, gynecomastia Checks for peripheral oedema Requests set of observations Abdominal Exam Ensures the patient is lying flat Inspects abdomen from the front and side Asks patient to identify their maximal point of tenderness Palpate each of the 9 quadrants beginning at a point furthest away from pain Palpates both superficially for pain and deeply for masses Ballots kidneys & checks for renal angle tenderness Palpates the aorta Checks for splenomegaly by palpating from RIF toward LUQ Checks for hepatomegaly by palpating from RIF toward RUQ Checks for murphys signs by palpating RUQ and asking the patient to breath in Percusses abdomen including checking for the bladder, liver edge, and spleen Offers to inspect groin e.g. hernia swelling Auscultation Auscultates for bowel sounds Auscultates for renal bruits Special Tests Percusses for shifting dullness / ascites Complete Examination Prompts patient to redress Summarises by stating they would complete a full history, PR if required, review the patients notes, and offers to discuss with senior Diagnosis and Interpretation Requests appropriate investigation (Bedside, Bloods, Imaging, Special tests) Gives appropriate differential Management Offers an appropriate management plan Submit Benjamin Armstrong
Abdominal Exam AllAbdominal Jul 17 Written By Benjamin Armstrong Intro Candidate introduces self with full name and role Adheres to appropriate infection control measures Asks patient if they are in any pain prior to beginning examination Gains consent Initial Inspection Adequately exposes the patient Identifies findings around the examination space Comments on patients appearance from the end of the bed Peripheral Examination: Inspects hands, arms, and axilla e.g. palmar erythema, nail changes, needle marks, fistula, acanthosis nigricans Checks radial pulse Checks for asterixis / flapping tremor Inspects face and mouth e.g. erythema, glossitis, ulcers Inspects neck for JVP Palpates supraclavicular nodes for lymphadenopathy Inspects chest e.g. spider naevi, gynecomastia Checks for peripheral oedema Requests set of observations Abdominal Exam Ensures the patient is lying flat Inspects abdomen from the front and side Asks patient to identify their maximal point of tenderness Palpate each of the 9 quadrants beginning at a point furthest away from pain Palpates both superficially for pain and deeply for masses Ballots kidneys & checks for renal angle tenderness Palpates the aorta Checks for splenomegaly by palpating from RIF toward LUQ Checks for hepatomegaly by palpating from RIF toward RUQ Checks for murphys signs by palpating RUQ and asking the patient to breath in Percusses abdomen including checking for the bladder, liver edge, and spleen Offers to inspect groin e.g. hernia swelling Auscultation Auscultates for bowel sounds Auscultates for renal bruits Special Tests Percusses for shifting dullness / ascites Complete Examination Prompts patient to redress Summarises by stating they would complete a full history, PR if required, review the patients notes, and offers to discuss with senior Diagnosis and Interpretation Requests appropriate investigation (Bedside, Bloods, Imaging, Special tests) Gives appropriate differential Management Offers an appropriate management plan Submit Benjamin Armstrong
