The Abdomen

The Abdomen
Group 1
ANATOMY
Abdominal Quadrants Abdominal Regions
ANATOMY OF
ABDOMEN
Abdominal Wall Muscles
ANATOMY OF
ABDOMEN
Abdominal Viscera
ANATOMY OF ABDOMEN Abdominal and Vascular Structures
(Aorta and Iliac Artery and Vein)
Position of the Kidneys

SUBJECTIVE ASSESSMENT
History of Present Health Concern: Abdominal Pain Questions
● Do you experience abdominal pain? If the client answers yes, use COLDSPA to explore the symptom.
Characteristics: Describe the pain (dull, aching, burning, gnawing, pressure, colicky, sharp, knife-like, stabbing,
throbbing, variable)
Onset: When did (does) the pain begin?
Locations: Point to the area where you have this pain. Does it radiate or spread to other areas? Where is the pain
located? Does it move or has it changed from the original location?
Duration: How long does the pain last?
Severity: How bad is the pain (severity) on a scale of 1 to 10, with 10 being the worst?
Pattern: When does the pain occur (timing and relation to particular events such as eating, exercise, bedtime)?
What seems to bring on the pain (precipitating factors), make it worse (exacerbating factors), or make it better (alleviating
factors)?
Associated Factors: Is the pain associated with any other symptoms such as nausea, vomiting, diarrhea, constipation,
gas, fever, weight loss, fatigue, or yellowing of the eyes or skin?
History of Present Health Concern: Indigestion Questions
● Do you experience indigestion? If the client answers yes, use COLDSPA to explore the symptom.
Characteristics: Describe how this feels.
Onset: When did you first experience this? When does this usually begin?
Locations: Point to where you usually feel indigestion.
Duration: How long does the indigestion last? How often does it recur?
Severity: Describe the severity of this feeling on a scale of 1–10 (10 being the worst). Does the indigestion
cause you to quit any of your activities of daily living if it occurs? What activities can you not do when you have
indigestion?
Pattern: Does anything in particular seem to cause or aggravate the indigestion? Have you noticed that this
sensation occurs after you eat certain foods?
Associated Factors: Do you have other symptoms with indigestion, such as nausea, vomiting, diarrhea or
constipation
History of Present Health Concern: Nausea and Vomiting Questions
● Do you experience nausea or vomiting? Describe it. Is it triggered by any particular

activities, events, or other factors (smells, eating of certain foods, and riding in a
car, boat, or plane, or strenuous physical exercise)?
History of Present Health Concern: Appetite Questions
● Have you noticed an increase or decrease in your appetite? Has this change
affected how much you eat or your normal weight? When did it begin? Does it come
and go? What other illnesses or life events were you experiencing when this
occurred? Is there anything that aggravates or improves this appetite change?
History of Present Health Concern: Bowel Elimination Questions
● Describe your stools (how many a day and consistency and color). Have you
experienced a change in bowel elimination patterns?
● Do you have constipation? Describe. Do you have any accompanying symptoms?
● Have you experienced diarrhea? Describe. Do you have any associated symptoms?
● Have you experienced any yellowing of your skin or whites of your eyes, itchy skin,
dark urine (yellow brown or tea colored), or clay-colored stools?
Personal Health History: Questions
● Have you ever had any of the following gastrointestinal disorders: ulcers,
gastroesophageal reflux, inflammatory or obstructive bowel disease, pancreatitis,
gallbladder or liver disease, diverticulosis, or appendicitis?
● Have you had any urinary tract disease such as infections, kidney disease or
nephritis, or kidney stone?
● Have you ever had viral hepatitis (type A, B, or C)? Have you ever been exposed to
viral hepatitis?
● Have you ever had abdominal surgery or trauma to the abdomen?
● What prescription or over-the-counter (OTC) medications do you take? Is there a
history of any of the following diseases or disorders in your family: colon, stomach,
pancreatic, liver, kidney, or bladder cancer; liver disease; gallbladder disease;
kidney disease?
Family History: Questions
● Has anyone in your family had any type of gastrointestinal cancer or other GI
disorders?
Lifestyle and Health Practices: Questions

● Do you drink alcohol? How much? How often?
● What types of foods and how much food do you typically consume each day? How
much non caffeinated fluid do you consume each day? How much caffeine do you
think you consume each day (e.g., in tea, coffee, chocolate, and soft drinks)?
● How much and how often do you exercise? Describe your activities during the day.
● What kind of stress do you have in your life? How does it affect your eating or
elimination habits?
● If you have a gastrointestinal disorder, how does it affect your lifestyle and how you
feel about yourself?
TOOLS
EQUIPMENT TO USE IN PHYSICAL ASSESSMENT
SMALL PILLOW
CENTIMETER RULER
MARKING PEN
STETHOSCOPE (WARM THE
DIAPHRAGM AND BELL)
PHYSICAL ASSESSMENT
ASSESSMENT PROCEDURE: Inspection
● Observe the coloration of the skin

● Note the vascularity of the abdominal
skin
● Note any striae (stretch marks)
● Inspect for scars
● Assess for lesions and rashes
● Inspect the umbilicus
● Observe umbilical location
● Assess contour of umbilicus

● Inspect abdominal contour
● Inspect abdominal movement when

the client breathes (respiratory
movements)
● Observe aortic pulsations
● Observe for peristaltic waves
ASSESSMENT PROCEDURE: Auscultation
● Auscultate for bowel sounds

● Auscultate for vascular sounds
● Listen for venous hum
● Auscultate for a friction rub
over the liver and spleen
ASSESSMENT PROCEDURE: Percussion
● Percuss for tone all quadrants

● Percuss the span or height of the

liver by determining its lower and
upper borders
● Measure the distance between

the two marks: this is the span of
the liver
● Percuss the spleen.

● For detecting splenic
enlargement is to percuss the
last left interspace at the anterior
axillary line (AAL) while the client
takes a deep breath
● Perform blunt percussion on the
liver and the kidneys.
● Perform blunt percussion on the
kidneys at the costovertebral
angles
ASSESSMENT PROCEDURE: Palpation
● Perform light palpation.
● Deeply palpate all quadrants to
delineate abdominal organs and
detect subtle masses.
● Palpate for masses. Note their
location, size (cm), shape,
consistency, demarcation,
pulsatility, tenderness, and
mobility
● Palpate the umbilicus and
surrounding area for swellings,
bulges, or masses.
● Palpate the aorta.
● Palpate the liver.
● To palpate by hooking, stand to
the right of the client’s chest.
Curl (hook) the fingers of both
hands over the edge of the right
costal margin. Ask the client to
take a deep breath and gently
but firmly pull inward and upward
with your fingers
● Palpate the spleen.
● Palpate the kidneys.
● Palpate the urinary bladder
ASSESSMENT PROCEDURE: Test for ascites
● Test for shifting dullness
● Perform the fluid wave test.
ASSESSMENT PROCEDURE: TESTS FOR APPENDICITIS
● Assess for rebound tenderness

● Palpate the urinary bladder
● Test for referred rebound
tenderness
ASSESSMENT PROCEDURE: TESTS FOR APPENDICITIS
● Assess for psoas sign.

● Assess for obturator sign.
● Perform hypersensitivity test.
ASSESSMENT PROCEDURE: TEST FOR CHOLECYSTITIS
● Assess RUQ pain or tenderness,

which may signal cholecystitis
(inflammation of the gallbladder).
Press your fingertips under the
liver border at the right costal
margin and ask the client to
inhale deeply
ABNORMAL FINDINGS
ABNORMAL FINDINGS: Abdominal Distention
●
ABNORMAL FINDINGS: Abdominal Distention
●
ABNORMAL FINDINGS: Abdominal Bulges
●
ABNORMAL FINDINGS: Abdominal Bulges
●
ABNORMAL FINDINGS: Enlarged Abdominal Organs and Other Abnormalities
●
●

The Abdomen

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The Abdomen

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The Abdomen

Position of the Kidneys

Onset: When did (does) the pain begin?

Duration: How long does the pain last?

Characteristics: Describe how this feels.

Locations: Point to where you usually feel indigestion.

● Do you experience nausea or vomiting? Describe it. Is it triggered by any particular

History of Present Health Concern: Appetite Questions

Lifestyle and Health Practices: Questions

● Observe the coloration of the skin

● Assess contour of umbilicus

● Inspect abdominal movement when

● Auscultate for bowel sounds

● Percuss for tone all quadrants

● Percuss the span or height of the

● Measure the distance between

● Percuss the spleen.

● Assess for rebound tenderness

● Assess for psoas sign.

● Assess RUQ pain or tenderness,

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