Health Assessment Nr304

Front 1

right upper quadrant

Back 1

The liver
The gallbladder,
The duodenum,
The head of the pancreas,
The right kidney and adrenal gland,
The hepatic flexure of the colon,
And part of the ascending and transverse colon.

Front 2

left upper quadrant

Back 2

o The stomach,
o The spleen,
o The left lobe of the liver,
o The body of the pancreas,
o The left kidney and adrenal gland,
o The splenic flexure of the colon,
o And part of the transverse and descending colon.

Front 3

right lower quadrant

Back 3

o The cecum,
o The appendix,
o The right ureter,
o And the right ovary and fallopian tube (in women), or the right spermatic cord (in men).

Front 4

left lower quadrant

Back 4

o A part of the descending colon,
o The sigmoid colon,
o The left ureter,
o And the left ovary and fallopian tube (in women), or the left spermatic cord (in men).

Front 5

midline of the abdomen

Back 5

o The aorta,
o The bladder (if distended),
o And the uterus (if enlarged in women).

Front 6

subjective data

Back 6

o Appetite,
o Dysphagia (or difficulty swallowing),
o Food intolerances,
o Abdominal pain,
o Nausea and vomiting,
o Bowel habits and the use of laxatives,
o Past abdominal history,
o Any current medications,
o And nutrition.

Front 7

objective data

Back 7

make sure that the patient’s abdominal wall is relaxed and that his or her bladder is empty. Then use the proper sequence to examine the abdomen.

Front 8

inspect the abdomen.

Back 8

o Note its contour and symmetry, the shape of the umbilicus, and the condition of the skin.
o Look for any pulsations or movement.
o Observe the pattern of pubic hair growth and the patient’s demeanor.

Front 9

auscultate the abdomen

Back 9

Do this before percussion and palpation because they can increase peristalsis, which may cause misinterpretation of bowel sounds.
o Note the character and frequency of bowel sounds. Normal bowel sounds can occur 5 to 30 times per minute, but listen for up to 5 minutes before deciding that bowel sounds are completely absent.
o Also, auscultate to detect any vascular sounds or bruits.

Front 10

Percuss

Back 10

the abdomen to assess the relative density of its contents. Because of air in the intestines, tympany is the predominant sound. Dullness may be heard over a distended bladder, adipose tissue, fluid, or a mass.

Front 11

Percuss

Back 11

Percuss to determine the borders of the liver and spleen.

Front 12

Percuss

Back 12

Use indirect first percussion to assess for costovertebral angle tenderness.

Front 13

Percuss

Back 13

If you suspect ascites, use percussion to test for a fluid wave and for shifting dullness.

Front 14

palpate the abdomen

Back 14

to judge the size, location, and consistency of certain organs and to screen for an abnormal mass or tenderness.

Front 15

Palpation

Back 15

1) Begin with light palpation to form an overall impression of the skin surface and superficial musculature. Note any guarding.

Front 16

Palpation

Back 16

2) perform deep palpation, pushing down about 5 to 8 centimeters. If you detect a mass, note its location, size, shape, consistency, surface, mobility, pulsatility, and tenderness.

Front 17

Palpation

Back 17

3) Then palpate for the liver in the right upper quadrant, the spleen in the left upper quadrant, the kidneys in both flanks, and the aorta just left of midline

Front 18

Palpation

Back 18

4) If needed, perform special procedures. For example, assess for rebound tenderness or inspiratory arrest, or perform the iliopsoas muscle test.