第六週｜Assessment of Abdomen–3ˍ賴維淑老師

Introduction

This tutorial provides a step-by-step guide on the assessment of the abdomen, based on the insights shared by Professor Lai Wei-Shu. Understanding abdominal assessment is crucial for healthcare professionals to diagnose and manage various conditions effectively. This guide will help you grasp the key techniques and considerations involved in abdominal examination.

Step 1: Prepare the Patient

• Explain the procedure to the patient to ensure comfort and cooperation.
• Position the patient in a supine position with their arms at their sides and legs slightly flexed to relax the abdominal muscles.
• Ensure the room is warm to avoid muscle contraction due to cold.

Step 2: Inspection of the Abdomen

• Look for any abnormalities or asymmetry in the abdomen.
• Observe the skin for color changes, scars, or lesions.
• Check for visible peristalsis or pulsations that may indicate underlying conditions.

Step 3: Auscultation of Bowel Sounds

• Use a stethoscope to listen to bowel sounds in all four quadrants.
• Normal bowel sounds are present and occur irregularly.
• Document any abnormal sounds such as hypoactive (decreased) or hyperactive (increased) bowel sounds, which may indicate issues like obstruction or inflammation.

Step 4: Percussion of the Abdomen

• Gently tap on the abdomen to assess for fluid, air, or solid masses.
• Use direct percussion (tapping directly on the abdomen) and indirect percussion (placing a hand on the abdomen and tapping it) for better results.
• Note the areas of dullness (indicating fluid or solid) and resonance (indicating air).

Step 5: Palpation of the Abdomen

• Start with light palpation to assess for tenderness, muscle resistance, or superficial masses.
• Gradually move to deep palpation to evaluate the size, shape, and consistency of internal organs.
• Be attentive to the patient's reactions, as pain may indicate underlying issues.

Step 6: Special Maneuvers

• Perform specific tests if needed, such as:
  • Murphy's sign for gallbladder inflammation.
  • McBurney's point tenderness for appendicitis.
• Always correlate findings with the patient’s history and presenting complaints.

Conclusion

Proper abdominal assessment is a critical skill for healthcare providers. By following these steps—preparing the patient, conducting thorough inspections, auscultation, percussion, and palpation—you can effectively evaluate abdominal health. Remember to document your findings carefully and consider further diagnostic tests if abnormalities are detected. For next steps, consider practicing these techniques in a clinical setting or engaging in further studies on abdominal pathology.