Abdominal Exam

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