30 Questions
Which maneuver should be performed before auscultating the abdomen?
Percussion
What sounds should be listened for during auscultation of the abdomen?
Bowel sounds
What is the normal frequency of bowel sounds?
5 to 34 per minute
What do high-pitched tinkling sounds during auscultation suggest?
Intestinal obstruction
Which technique is used to estimate the size of the liver when direct examination is limited?
Percussion
What is the usual vertical span of liver dullness in centimeters?
2.5 to 4.5
How is the lower border of liver dullness identified during percussion?
Percuss upward toward the liver
What should be done if the liver seems enlarged during examination?
Outline the lower edge by percussing medially and laterally
Which maneuver is positive if withdrawal produces pain?
Pressing down with fingers firmly and slowly
What is the purpose of the Rovsing sign?
To assess for appendicitis
What is the significance of the Murphy sign?
It indicates acute cholecystitis
What does the presence of Cullen sign indicate?
Hemoperitoneum
Which technique should never be used alone to diagnose pathology or 'rule out' a condition?
Cough test
What is a sign of peritonitis that involves the voluntary contraction of the abdominal wall?
Guarding
What is the purpose of palpation in assessing possible peritonitis?
To identify the area of pain
What is the normal state of the bladder in terms of palpability?
Never palpable
Which order should the exam maneuvers be performed in?
- Inspection, 2. Auscultation, 3. Percussion, 4. Palpation, 5. Rectal exam
What is the recommended patient position for the abdominal exam?
Supine with head supported, knees may need support as well, arms at sides or over chest
What should be used to cover the chest/breasts during the abdominal exam?
Gown
How should the examiner handle a patient who is frightened or ticklish during the abdominal exam?
Distract the patient with questions during the exam
Which course will teach you the skill of documenting abdominal findings?
Course 72
Which of the following is NOT mentioned in the example documentation of a basic abdominal assessment?
Palpable masses
Which part of the abdomen is described as protuberant with active bowel sounds?
Right midclavicular line
Which organ is NOT felt during the abdominal assessment?
Bladder
Which part of the abdomen exhibits increased tenderness, guarding, and rebound in the example documentation?
Right midquadrant
What is the liver span mentioned in the example documentation?
7 cm
Which technique can be used for liver palpation in obese patients?
Using the hooking technique
How does the spleen enlarge?
Anteriorly, downward, and medially
How can the spleen be palpated?
By pressing forward on the lower left rib cage
How can the right kidney be palpated?
From the patient's right side by lifting up beneath the kidney
Study Notes
Abdominal Organ Palpation Techniques
- Liver palpation is done by placing the right hand on the patient's right abdomen and pressing gently upwards.
- The liver edge should feel soft, sharp, and regular with a smooth surface.
- The "hooking" technique can be used for liver palpation in obese patients.
- The spleen enlarges anteriorly, downward, and medially, and becomes palpable below the costal margin.
- To palpate the spleen, the patient should relax with arms at the sides, and the lower left rib cage should be pressed forward while applying pressure below the left costal margin.
- The spleen can also be palpated when the patient is lying on the right side with legs flexed.
- The kidneys are usually not palpable, but palpation techniques can help distinguish enlarged kidneys from other abdominal masses.
- Palpation of the left kidney can be done from the patient's left side by placing the right hand below the 12th rib and the left hand in the LUQ.
- Palpation of the right kidney can be done from the patient's right side by lifting up beneath the kidney.
- The size, contour, and tenderness of the kidneys should be assessed during palpation.
- Kidney percussion can be done by using fist percussion in the CVA to elicit tenderness.
- The aortic pulsations can be detected by pressing deep in the epigastrium, slightly to the left of the midline. A normal aorta should not be more than 3 cm wide.
Test your knowledge on abdominal organ palpation techniques! This quiz will cover liver, spleen, and kidney palpation methods, as well as important considerations for assessing size, tenderness, and contour. Learn how to distinguish between normal and enlarged organs, and discover tips for effectively palpating in different patient positions.
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