7/18/2020 Abdominal Exam

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Abdominal Exam
Please assess the student performing a full abdominal exam.

Student's Email: Home

Perform an
GENERAL - Observe the student doing the following: (More info) Assessment

Washes hands Blood Pressure and

Pulse
Done Not done
Abdominal Exam
Introduces self and exam to patient
Done correctly Done incorrectly Not done Full Abdominal Exam

Focused Liver Exam

Appropriate draping of patient
Expose from the nipple line to the ASIS Focused Spleen
Done correctly Done correctly with minor omissions Exam
Done incorrectly Not done General Abdominal
Exam

Respiratory Exam
INSPECTION - The student should comment on the following:
(More info) Precordial Exam

Patient's general appearance Jugular Venous

Ex: writhing, still, cachectic, generally well/unwell etc. Pressure
Done correctly Done correctly with minor omissions
Thyroid/Head & Neck
Done incorrectly Not done
Lymph Nodes Exam
Abdominal contour
Knee Exam
Ex: masses, symmetry etc.
Done correctly Done correctly with minor omissions Back Exam
Done incorrectly Not done
Hip Exam
Scars
GALS Exam

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Abdominal Exam Peripheral Vascular

Ex: RLQ for appendectomy, midline for laparotomy etc. Exam (PVD)
Done correctly Done correctly with minor omissions
Cranial Nerves
Done incorrectly Not done
Knee & Ankle Reflexes
Pulsations
Ex: Epigastric from abdominal aortic aneurysm Sensory Exam
Done correctly Done correctly with minor omissions
Perform an
Done incorrectly Not done
Assessment
Ascites
Supplemental
Best observed from the foot of the bed (bulging flanks) Information
Done correctly Done correctly with minor omissions
Done incorrectly Not done Complete a PCEC

Skin changes or discolorations Get in touch

Ex: Petechiae, ecchymoses, purpura, lesions, Cullen/Grey Turner's
sign
Done correctly Done correctly with minor omissions
Done incorrectly Not done

INSPECTION FOR STIGMATA OF LIVER DISEASE - The student

should comment on the following: (More info)

Nail changes
Ex: Clubbing, leukonychia or Terry's nails
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Hand changes
Ex: Palmar erythema, Dupuytren's contracture, thenar wasting
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Asterixis
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Temporal muscle wasting

Done correctly Done correctly with minor omissions
Done incorrectly Not done

Scleral icterus
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Fetor Hepaticus
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Gynecomastia
Done correctly Done correctly with minor omissions
Done incorrectly Not done

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Abdominal Exam
Spider angiomas or telangiectasias
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Caput Medusae
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Testicular atrophy
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Inspect for peripheral edema

Done correctly Done correctly with minor omissions
Done incorrectly Not done

AUSCULTATION - Observe the student performing the following

manoeuvers: (More info)

Auscultates for bowel sounds in all 4 quadrants

Done correctly Done correctly with minor omissions
Done incorrectly Not done

Auscultates for aortic, renal, common iliac, femoral and hepatic bruits
Done correctly Done correctly with minor omissions
Done incorrectly Not done

PERCUSSION - Observe the student performing the following

manoeuvers: (More info)

Percusses in all 4 quadrants

Comments on quality of percussion sounds
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Measures liver span & comments on expected findings

Percuss down from clavicle and up from RLQ along the
midclavicular line
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Percuss in Traube's Space for splenic enlargement & comments on

expected findings
Percuss in triangle bordered by 6th rib, anterior axillary line, & costal
margin on the left side
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Castell's method for splenic enlargement & comments on expected

findings

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Abdominal Exam
Percuss in lowest left IC space @ the anterior axillary line during
inspiration
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Attempts to elicit costovertebral angle tenderness

Fist percussion at costovertebral angle for pyelonephritis
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Tests for ascites & comments on expected findings

Shifting dullness and fluid wave test
Done correctly Done correctly with minor omissions
Done incorrectly Not done

PALPATION - Observe the student performing the following

manoeuvers: (More info)

Light palpation in all 4 quadrants

Palpating for abnormalities in the abdominal wall (ex: hernia)
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Deep palpation in all 4 quadrants

Palpating for abdominal masses
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Palpate liver edge & comment on expected findings

Palpate up from RLQ for liver enlargement
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Palpate for splenic enlargement & comment on expected findings

Palpate from RLQ to the LUQ
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Ballottement of kidney
Done correctly Done correctly with minor omissions
Done incorrectly Not done

SPECIAL TESTS - Observe the student performing the following

manoeuvers: (More info)

Rebound tenderness
Increased tenderness upon release of pressure on abdomen
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Rovsing's sign

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Abdominal Exam
Tenderness in RLQ upon palpation of LLQ
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Tenderness at McBurney's point

Done correctly Done correctly with minor omissions
Done incorrectly Not done

Psoas test
Pain upon passive extension of the right hip
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Obturator test
Pain upon internal rotation of the right hip
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Attempts to elicit Murphy's sign

Abrupt interruption of inspiration upon palpation over gallbladder
Done correctly Done correctly with minor omissions
Done incorrectly Not done

Offers to perform a digital rectal exam

Done correctly Done correctly with minor omissions
Done incorrectly Not done

GLOBAL RATING SCALES - Please rate the student on their

overall performance:

Understands rational of manoeuvers and findings

Excellent Good Satisfactory Poor Fail

Organized approach
Excellent Good Satisfactory Poor Fail

Sensitivity toward patient concerns and comfort during the

examination
Excellent Good Satisfactory Poor Fail

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