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Good Morning Doctors

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Good Morning Doctors, PGIs and fellow clerks.

Today, we will be presenting to you the physical


examination of the abdomen. So before we start, may I ask CC ____ to lead us in prayer.

These are the objectives for this presentation:

Before we proceed to the 4 sections of the examination, Let’s have an overview of the
abdomen.

The abdomen
The purpose of the abdominal divisions is to describe regional anatomy in the abdomen,
and to help clinicians determine which organ and tissues are involved in a disease
based on which regions experience pain.

The division into four quadrants allows the localization of pain and tenderness, scars,


lumps, and other items of interest, narrowing in on which organs and tissues may be
involved.

The abdominopelvic cavity can be subdivided into four quadrants


and nine regions. The quadrants represent locations; they are formed
by a vertical imaginary line drawn through the linea alba from the
xiphoid process of the sternum to the pubic symphysis and a
horizontal line passing through the umbilicus. This divides the
abdomen into four quadrants. The quadrants are labeled by location: the right
upper, right lower, left upper, and left lower quadrants.

1. The navel (belly button) is the landmark you’ll use to visualize these quadrants
while doing assessments. This is the point at which the two planes cross.
2. The terms “left/right” and “upper/lower” are always from the perspective of
the anatomical position, not your perspective

Nine regions of the abdomen can be marked using two horizontal and two vertical dividing lines. The
vertical lines are the mid-clavicular lines taken from the mid-point of each clavicle. The upper
horizontal line is the subcostal line taken from the inferior parts of the lowest costal cartilages. The
lower horizontal line is the intertubercular line connecting the tubercles of the pelvis.
The nine regions are smaller than the four abdominopelvic quadrants and include the
right hypochondriac, right lumbar, right illiac, epigastric, umbilical, hypogastric (or
pubic), left hypochondriac, left lumbar, and left illiac divisions.

The abdomen can be separated into individual regions to more precisely depict
anatomical location. A classical distribution consists of 4 quadrants that are separated
right from left by a single vertical plane and superior from inferior by a horizontal plane.
Another common scheme divides the anterior abdominal wall into 9 anatomical regions.
As part of this distribution, the upper middle and lower abdomen are separated into
thirds. This regions enable more specific findings during examination.

In contrast to examining the chest, auscultation of the abdomen should occur before
palpation otherwise stimulation of the bowels may trigger a false increase in peristalsis.

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