Transcript Assessment of the Abdomen

Assessment of the Abdomen
By Freida Fuller-Jonap
fulerjonap_f
678-547-6742
The Abdominal Assessment
Includes
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the lower end of the
esophagus
stomach
kidneys
edge of the urinary
bladder
spleen
liver
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gallbladder
uterus
large and small
intestines
peritoneum
Health History Data Should
Include
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Diet nutrition
level of stress
alcohol/cigarette
smoking
medications
stood
urinary
exposure to infectious
disease
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possibility of
pregnancy
family history
previous GI or GU
trauma
specific problems
related to GI tract and
GU system
Assessment should occur in a
particular order
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Inspection
Ausculatation
Percussion
Palpation
Inspection
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Skin: color, texture, scars, lesions, striae,
rashes, wounds, incisions, ostomies, etc
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Color:
Grey Turner Sign
 jaundice
 ascites
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Vascularity
Striae
Inspect the Umbilicus
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Cullen’s sign
Contour: flat, rounded, concave, protuberant
Assymetry
Masses
Movement
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Pulsations of the aorta
Peristalsis of intestines
Auscultation
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Bowel sounds
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hyperactive
hypoactive
Absent
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Vascular Sounds
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Bruits
aorta
 renal arteries
 iliac arteries
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Friction Rubs
Percussion
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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
Palpation
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Light palpation
Deep palpation
Palpation of the Liver
Palpation of the spleen
Palpating kidneys
Palpating the urinary bladder
Special Abdominal Tests
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Ascites
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Fluid Wave
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Fluid Shift
Special Abdominal Tests
(continued)
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Ballottement Technique
Appendicitis
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Rebound tenderness (Blumberg’s sign
Rovsing’s
Referred rebound tenderness
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Psoas
Oburator sign
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Acute cholecystitis
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Murphy’s sign
Diagnostic Testing
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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
Tests for Gallbladder Diseases
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Bilirubin
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Direct
Indirect
Diagnostic Study for the
Pancreas
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Serum Amylase
Liver Studies
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Ammonia: hepatitis, cirrhosis, hepatic
encephalopathy
Prothrombin Time: cirrhosis, hepatitis, bile
duct obstruction,
ALT (alanine aminotransferase: hepatitis,
liver necrosis, cirrhosis, cholestasis, tumor
and hepatotoxic drugs
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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
Diagnostic Tests for Kidney
Disorders
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BUN: metabolic function of the liver and
excretory function of the kidney
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Increased: renal disease/failure, nephrotoxic drugs
GI bleeding, excessive protein ingestion
Decreased: Liver failure, overhydration,
malnutrition, malabsorption, nephrotic syndrome
Creatinine
Potassium
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Urinalysis
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Protein
Leukocyte esterase
Nitrates
Urine for C & S
IVP: intravenous pyelogram
KUB: Kidneys, ureters, bladder
Diagnostic Tests for
Gastrointestinal System
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EGD (esophagogastroduodenoscopy):
tumors, esophageal diverticula, hiatal
hernia, esophagitis, gastritis…
Barium enema
Barium Swallow
Colonoscopy
Sigmoidoscopy