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Per-Abdomen Examinatio

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Surface Topography :

1. Four quadrant pattern

2. Nine quadrant pattern

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Method of examination :
1. History
2. Chief complaints
3. Examination
I) Physical examination
1.Inspection
II) Abdominal examination 2.Palpation
3.Percussion
III) General examination 4.Auscultation

IV) Hematological Investigations


V) Radiological examination 3
History
1. Age Conditions particularly seen at a definite age group
( Newborns/Infants/Children/Adults/Aged )
2. Sex ( Male/Female )
3. Occupation
4. Place and Food Habits
5. Economical and Social status
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Personal History
Habits
Menstrual history

Past History
Medicinal History
Surgical history

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Chief complaints
1. Pain
Time of onset
Mode of onset
History of complaint of pain
Site of pain
Shifting of pain
Radiation of pain
Referred pain
Characteristics of pain Relieving and Aggravating factors
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2. Vomiting
Character of the act
Nature of vomitus
Frequency
Quantity
Relationship with pain

3. Diarrhoea and Constipation :


Tenesmus
4. Micturation :
Stranguary
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5. Jaundice
6. Association with
Fever
Chills
Burning micturition

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Physical examination
1. Built and nutrition
2. Appearance
3. Attitude
4. Pulse rate and Blood Pressure
5. Respiration
6. Temperature
7. Tongue
8. Lymphadenopathy

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Abdominal examination
Examination of the abdomen should be done in bright light, preferably
in day light
During examination the patient should lie supine with his legs extended
Area of examination should be exposed From nipples to saphenous
openings
Examination should always be done with warm hands

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I. Inspection
1. Appearance :
Symmetry
Flat / Scaphoid abdomen

2. Distension :
Gradual onset / Sudden onset
Central / Peripheral

3. Localized swellings
4. Respiratory movements
5. Peristaltic movements 11
6. Skin :
Discoloration Linea nigra of Pregnancy
Bruising
Cullens sign
Grey Turners sign
Scars
Hair Altered in case of Liver diseases and Endocrine
abnormalities
Striae Striae of abdominal wall are produce as result of rupture
of the reticular dermis that occurs with stretching.
Veins
Engorgement of the veins and the direction of the flow of
blood in them should be noted
Above the umbilicus, blood flow is normally upward, below the
umbilicus, it is normally downwards. ( Water Shed line ) 12
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