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Abdominal Examination

The OSCE checklist provides guidance for examining a patient's abdomen through inspection, palpation, percussion, and auscultation. Key steps include inspecting the patient's general appearance, hands, arms, face, neck, chest and abdomen. Palpation of the abdomen assesses the liver, gallbladder, spleen, kidneys, aorta and bladder. Percussion locates the liver and spleen borders while auscultation evaluates bowel sounds and checks for bruits over the aorta and renal arteries. The examination is completed by assessing the legs, explaining findings to the patient, and suggesting further assessments.

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1K views2 pages

Abdominal Examination

The OSCE checklist provides guidance for examining a patient's abdomen through inspection, palpation, percussion, and auscultation. Key steps include inspecting the patient's general appearance, hands, arms, face, neck, chest and abdomen. Palpation of the abdomen assesses the liver, gallbladder, spleen, kidneys, aorta and bladder. Percussion locates the liver and spleen borders while auscultation evaluates bowel sounds and checks for bruits over the aorta and renal arteries. The examination is completed by assessing the legs, explaining findings to the patient, and suggesting further assessments.

Uploaded by

Bassam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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  • Arms and Axilla
  • Neck
  • General Inspection
  • Introduction
  • Hands
  • To complete the examination
  • Legs
  • Abdominal Inspection
  • Abdominal Palpation
  • Abdominal Percussion

OSCE Checklist: Abdominal Examination

Introduction
1 Wash your hands and don PPE if appropriate

2 Introduce yourself to the patient including your name and role

3 Confirm the patient's name and date of birth

4 Briefly explain what the examination will involve using patient-friendly language

5 Gain consent to proceed with the examination

6 Adjust the head of the bed to a 45° angle

7 Adequately expose the patient

8 Ask if the patient has any pain before proceeding

General inspection
9 Inspect for clinical signs suggestive of underlying pathology (e.g. confusion, pain, noticeable
scars, abdominal distension, pallor, jaundice, hyperpigmentation, oedema, cachexia, hernias)
10 Look for objects or equipment on or around the patient (e.g. stoma bag(s), surgical drains,
feeding tubes, medications, catheters)

Hands
11 Inspect the palms for pallor, palmar erythema and Dupuytren’s contracture

12 Inspect for nail signs including koilonychia and leukonychia

13 Assess for finger clubbing

14 Assess for asterixis

15 Assess and compare the temperature of the hands

16 Palpate and assess the radial pulse

17 Palpate for Dupuytren’s contracture

Arms and axillae


18 Inspect the patient’s arms for bruising, excoriations and needle track marks

19 Inspect the axillae for acanthosis nigricans and hair loss

Face
20 Inspect the eyes for signs suggestive of gastrointestinal pathology (e.g. conjunctival pallor,
jaundice, corneal arcus, xanthelasma, Kayser-Fleischer rings, perilimbal injection)
21 Inspect the mouth for signs suggestive of gastrointestinal pathology (e.g. angular stomatitis,
glossitis, oral candidiasis and aphthous ulceration)

Neck
22 Palpate for lymphadenopathy in the supraclavicular fossae (paying particular attention to the
left supraclavicular fossa for Virchow’s node)

Inspect the chest


23 Inspect the chest for signs suggestive of gastrointestinal pathology (e.g. spider naevi,
gynaecomastia and hair loss)

Abdominal inspection
24 Position the patient lying flat on the bed (arms by their side & legs uncrossed)

25 Inspect the patient’s abdomen for signs suggestive of gastrointestinal pathology (e.g. scars,
Cullen’s sign, Grey-Turner’s sign, striae, abdominal distension, hernias, stomas)

Abdominal palpation
26 Check if the patient has any abdominal pain before palpating (if so, these areas should be
examined last)
27 Perform light palpation of the abdomen across all nine regions

28 Perform deep palpation of the abdomen across all nine regions

29 Palpate the liver

30 Palpate the gallbladder

31 Palpate the spleen

32 Ballot the kidneys

33 Palpate the aorta

34 Palpate the bladder

Abdominal percussion
35 Perform hepatic percussion to identify the liver’s borders

36 Perform splenic percussion

37 Perform bladder percussion

38 Assess shifting dullness

Abdominal auscultation
39 Auscultate the abdomen to assess bowel sounds

40 Auscultate over the aorta for bruits

41 Auscultate over the renal arteries for bruits

Legs
42 Assess for pedal oedema

To complete the examination…


43 Explain that the examination is now finished to the patient

44 Thank the patient for their time

45 Dispose of PPE appropriately and wash your hands

46 Summarise your findings

47 Suggest further assessments and investigations (e.g. assessment of hernial orifices, digital
rectal examination, examination of external genitalia, abdominal imaging).

Read the full guide at Download our


[Link] GEEKY MEDICS clinical skills app

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