Physical Assessment: Abdomen Inspection

Physical Assessment: Abdomen

• Blunt percussion on the liver and kidneys can indicate tenderness or sharp pain, suggesting kidney infection, renal calculi, or hydronephrosis
• Light palpation of the four quadrants of the abdomen can detect involuntary reflex guarding, which may indicate peritoneal irritation
• Right-sided guarding may be due to cholecystitis
• Deep palpation of all quadrants can help delineate abdominal organs and detect subtle masses
• Severe tenderness or pain may be related to trauma, peritonitis, infection, tumors, or enlarged or diseased organs

Palpation of Abdominal Organs

• A wide, bounding pulse may be felt with an abdominal aortic aneurysm
• A hard, firm liver may indicate cancer
• Enlargement of the liver may be due to hepatitis, liver tumors, or cirrhosis
• An enlarged kidney may be due to a cyst, tumor, or hydronephrosis
• A palpable spleen suggests enlargement, which may result from trauma, chronic blood disorders, or cancers
• A distended bladder is palpated as a smooth, round, and somewhat firm mass extending as far as the umbilicus

General Inspection

• Nasal flaring and pursed lip breathing may indicate labored respirations or hypoxia
• Ruddy to purple complexion may be seen in COPD or CHF due to polycythemia
• Cyanosis may be seen in clients who are cold or hypoxic, appearing blue-tinged in the perioral, nailbed, and conjunctival areas
• Pale or cyanotic nails may be seen with hypoxia, leading to early or late clubbing

Posterior Thorax

• Scoliosis may have respiratory implications due to spinal configurations

Abdominal Inspection

• Dilated veins may be seen with cirrhosis of the liver, obstruction of the inferior vena cava, portal hypertension, or ascites
• Spider angioma may be seen with liver disease or portal hypertension
• Dark bluish-pink striae are associated with Cushing's syndrome or ascites, which stretches the skin
• Keloids result from trauma or surgery

Abdominal Contour

• Generalized protuberant or distended abdomen may be due to obesity, air or gas accumulation, or fluid accumulation
• Distention below the umbilicus may be due to a full bladder
• Distention of the upper abdomen may be seen with masses of the pancreas or gastric dilation
• Major causes of abdominal distention are referred to as the "6 Fs": Fat, feces, fetus, fibroids, flatulence, and fluid

Assess your knowledge of abdominal inspection in physical assessment, including observation of skin coloration, vascularization, scars, rashes, and lesions. Topics include cirrhosis of the liver, portal hypertension, and ascites.