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The liver scratch test can be used when other exam techniques used to approximate liver size are ineffective or unavailable [2] and is thought to be most useful if the abdomen is distended, too tender for direct palpation, the abdominal muscles are too rigid, or the patient is obese. [3]
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen.
The human abdomen is divided into quadrants and regions by anatomists and physicians for the purposes of study, diagnosis, and treatment. [1] [2] The division into four quadrants allows the localisation of pain and tenderness, scars, lumps, and other items of interest, narrowing in on which organs and tissues may be involved.
In medicine, Carnett's sign is a finding on clinical examination in which abdominal pain remains unchanged or increases when the muscles of the abdominal wall are tensed. [1] [2] For this part of the abdominal examination, the patient can be asked to lift the head and shoulders from the examination table to tense the abdominal muscles.
In medicine, Murphy's sign (also known as Sweeney’s sign) is a maneuver during a physical examination as part of the abdominal examination. [1] It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.
Left Upper Quadrant of the abdomen (Perisplenic view). Left upper quadrant is examined by working your probe down the midaxillary line starting at the left 8th rib to the 11th rib. This examines for free fluid around the kidney and spleen. Pelvic views (Long and transverse axis). The suprapubic view helps assess for free fluid in the pelvic cavity.
Tympanitic, drum-like sounds heard over air filled structures during the abdominal examination. [4] Hyperresonant (pneumothorax), said to sound similar to percussion of puffed up cheeks. Normal resonance/ Resonant, the sound produced by percussing a normal chest. Impaired resonance (mass, consolidation) lower than normal percussion sounds.
An abdominal reflex is a superficial neurological reflex stimulated by stroking of the abdomen around the umbilicus. It can be helpful in determining the level of a central nervous system (CNS) lesion. Being a superficial reflex, it is polysynaptic (involving multiple connections between nerves). [1]
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