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Week_7_Abdomen_Physical_Exam_Summary.pdf - Seidel: Mosby’s...

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Seidel: Mosby’s Guide to Physical Examination, 7thEditionChapter 17: AbdomenRTF-downloadable Physical Exam SummaryThis review discusses examination of the abdomen.Before the exam,gather the necessary equipment: stethoscope, centimeter ruler, non-stretch tape measure, and marking pen.To inspect the abdomen, perform the following.Using tangential lighting, inspect the abdomen for foursurface characteristics.oFirst, observe the skincolor. It may vary greatly, but should have no jaundice,cyanosis, redness, bruises, or discoloration.oSecond, check for nodules and otherlesions, which should not be present.oThird, note anyscarsand draw their location, configuration, and relative size onan illustration of the abdomen.oFourth, assess thevenous return. Above the umbilicus, venous return should betoward the head. Below the umbilicus, it should be toward the feet.Next, inspect the abdominalcontour and symmetry.oThecontouris the abdominal profile from the rib margin to the pubis. It normallymay be flat, rounded, or scaphoid. The umbilicus should be centrally located andmay be inverted or may protrude slightly.oContralateral areas of the abdomen should besymmetricalin appearance andcontour and should have no distention or bulges.oToelicit hidden masses or bulges, have the patient take a deep breath and hold it.The abdomen should remain smooth and symmetrical. Also have the supinepatient raise the head from the table as you inspect the abdomen. Note anymasses, hernia, or muscle separation.With the patient’s head at rest, observe for three types of abdominalmovement.oFirst, inspect for smooth, evenmovement with respiration.oSecond, assess forsurface motion from peristalsis. In a thin patient, it normallymay be visible. Otherwise, it may signal an intestinal obstruction.oThird, note anyaorticpulsation in the upper midline. Although pulsations maybe visible in a thin patient, marked pulsations suggest a disorder.

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Term
Summer
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Tags
Physical examination, Human rib cage

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