How to palpate the abdomen Wash hands Introduction Permission Expose- nipple to knee Re-position- lying down, hands

by sides.

General Inspection

Light palpation (kneel to lower level)

Deep palpation

Organ palpation (stand up for kidneys, aorta, bladder palpation)

To finish

Any visible distension, asymmetry, scars. Describe any of these in more detail if present (e.g. Scars- Size? Location? Age? Well-healed?) For tenderness- watch patients face when palpating. Palpate through all sections of abdomen. For masses- use more force, and explore abdomen. Still watch patients face mainly Liver- start in right iliac fossa, move upwards. Tell patient to breathe in and out; whilst patient is breathing in, move hand upwards to try and feel liver edge. Spleen- start in right iliac fossa, move diagnonally upwards towards left. Same as for liver, tell patient to breathe in and out; palpate for spleen during inspiration. Kidneys- Put right hand on anterior abdomen, left hand at the back. Lift kidney with bottom hand and try to feel with top hand. Aorta- put hands either side of umbilicus Bladder- Put hands either side below umbilicus Percuss Auscultate Examine hernial orifices Examine external genitalia Perform rectal examination Urine dipstick