Abdomen

Normal Abdomen Shape

Flat or rounded. Indicates normal muscle tone and weight distribution.

Distended Abdomen

Abnormal enlargement due to fluid, gas, or organ enlargement. Can indicate ascites, pregnancy, or bowel obstruction.

Scaphoid Abdomen

Concave or sunken appearance. Often seen in malnutrition or severe weight loss.

Protuberant Abdomen

Markedly rounded, often due to obesity, ascites, or mass.

Right Upper Quadrant (RUQ)

Contains the liver, gallbladder, right kidney, pancreas head, duodenum, and part of the ascending and transverse colon.

Left Upper Quadrant (LUQ)

Contains the stomach, spleen, left lobe of the liver, body of the pancreas, left kidney, and parts of the transverse and descending colon.

Right Lower Quadrant (RLQ)

Contains the cecum, appendix, right ovary and fallopian tube, right ureter, and right spermatic cord.

Left Lower Quadrant (LLQ)

Contains the sigmoid colon, left ovary and fallopian tube, left ureter, and left spermatic cord.

Midline Structures

Includes the aorta, bladder (if distended), and uterus (if enlarged).

Rebound Tenderness

Pain upon release of pressure, indicating peritoneal irritation (e.g., appendicitis).

Murphy's Sign

Pain upon palpation of the right upper quadrant during deep inspiration, indicating cholecystitis.

McBurney's Point

Located 1/3 of the way from the anterior superior iliac spine to the umbilicus. Tenderness indicates appendicitis.

Rovsing's Sign

Pain in the RLQ when palpating the LLQ, indicating peritoneal irritation or appendicitis.

Cullen's Sign

Bluish discoloration around the umbilicus, indicating intra-abdominal bleeding.

Grey Turner's Sign

Bluish discoloration of the flanks, indicating retroperitoneal hemorrhage.

Light Palpation

Gentle, circular pressing about 1 cm deep. Used to assess tenderness, muscle tone, and surface characteristics.

Deep Palpation

Firm, deep pressing about 4-5 cm deep. Used to assess organ size, masses, and areas of tenderness.

Guarding

Voluntary or involuntary muscle tension that may indicate pain, peritonitis, or inflammation.

Mass Assessment

Palpate for size, shape, consistency, and mobility of any masses.

Abdominal Aortic Pulse

Palpated in the upper midline abdomen. Normal width is 2.5 to 4 cm.

Hernia

Protrusion of an organ or tissue through an abnormal opening. Includes inguinal, umbilical, incisional, and femoral hernias.

Reducible Hernia

A hernia that can be pushed back into the abdominal cavity.

Incarcerated Hernia

A hernia that cannot be reduced, potentially leading to strangulation.

Strangulated Hernia

A hernia with compromised blood flow, requiring emergency surgical intervention.

Abdominal Assessment Order

Inspection → Auscultation → Percussion → Palpation. Auscultation is performed before palpation to avoid altering bowel sounds.

Abdominal Percussion

Assess for tympany (air) and dullness (solid organs, fluid, or mass). Normal over intestines, dull over liver and spleen.

Abdominal Auscultation

Listen for bowel sounds in all four quadrants. Normal is 5-30 sounds per minute. Absent sounds after 5 minutes indicate bowel obstruction or ileus.