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Skip to 0 minutes and 12 seconds Are you all right lying flat? Yeah. If you could lie right down for me then and just relax with your arms by your sides. I am going to examine your abdomen next, so first, I am going to just have a look. As always, the abdominal examination starts with inspection, looking for any scars, rashes, distension or pulsations which may indicate an abdominal aortic aneurysm, AAA. However, the next assessment is auscultation, to listen for bowel sounds in all four quadrants. That’s lovely, and the next thing I am going to do is just listen to it a little bit. Notice that when we examine the abdomen, we start with auscultation rather than palpation. The reasoning behind this is twofold. 1.

Skip to 0 minutes and 53 seconds To prevent disturbance of the gasses in the gut before we have heard the bowel sounds and 2. To avoid provoking guarding and rigidity in a peritonitic abdomen. Overloud tinkling sound may indicate obstruction or gastroenteritis. Lack of sounds may indicate an area of bowel beyond an obstruction or a paralytic ileum. I auscultate the aorta listening for bruits, then move to each renal artery and to the iliac arteries. After auscultation the abdominal examination progresses in the usual way.

What constitutes physical examination

Here we discuss the separate elements of physical examination, and when each element is required.

Physical examination is generally thought of as having four elements and is carried out in that order in the majority of examinations.

  • Inspection
  • Percussion
  • Palpation
  • Auscultation

Is it always appropriate to perform each of these elements? And is the order crucial?

Your task

Watch the short video of an abdomen examination above, and note the reason for auscultating before palpation or percussion.

Now investigate any information you can find that supports auscultating before palpation or percussion and share with the group.

Share your thoughts on the most appropriate examination process in the presentation of a sore throat.

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This video is from the free online course:

An Introduction to Physical Health Assessment

Coventry University