Dr.yarub
Abdominal examination:---indication for liver examination
1-pallor
2-jaundice
3-L.N enlargement
4-petechiae
Sometimes in GIT the C.C can be yellow discoloration of skin
Or yellow discoloration of urine
**After we complete the general exam Dysmorphic features:-
--Knee & elbowxanthomata
--eyelidsxanthelasma
--in hands 5 features:-
1-clubbing
2-koilonychia&leukonychia
3-skin lesion
4-palmar erythema
5-pallor
6-capillary refill time
7-RR,P.R,Temp
**Any intervention in the hand"cannula"
Inspection of Abdomen:-
1-umbilicus
2-abdominal distension
3-dilated veins
4-skin lesion "petechiae"
5-movement with respiration
6-visible peristalsis
7-scars
Palpation :-
a-sup.palpation:-
for detection of :- 1-mass
2-tenderness
b-deep palpation:-always be in same level with the pt
for:-
1-mass
2-tenderness
3-organomegaly
--when you feel an edge:-
1-surfacesmooth or nodular
2-edgesharp or rounded
3-consistencyfirm or smooth
**if rounded ,,smooth massacute
**sharp ,,firm chronic
**nodular chronic &malignancy
**normally liver is palpable for 1 yr
Massive splenomegaly:-
kala –azar
chronic myelogenous leukemia
myelofibrosis
malaria
e.g:-hard surface,notched,sharp edge,4cm below costal margin
**always put the tape measure obliquely on the spleen
**imp:spleen we can't get above it? The spleen is located under the ribcage
**Moderate splenomegaly:-
Cirrhosis
Sarcoidosis
Histoplasmosis
Brucellosis
**kidney examination:-
a-feel from above
b-push from below
**indication for bladder exam:1-neurogenic bladder in CP
2-Down syndrome
3-nephrotic syndrome
before u performed itask wether he voided or not
**palpation:-1-shifting dullness:- Turn the pt to your side &wait 15sec
2-transmitting thrill
**Auscultate :-bowel sounds
a-absent
b-exagerrated
c-present normal
d-sluggish:-paralytic ileus :loss of fluids &electrolytes in V &D"gastroenteritis"
**lastly say:- I should examine the
1-hernial orifices
2-gentilia 3-P.R **Bp :has relation to Ht