Abdominal Assessment

4 Quadrants

RUQ, LUQ, RLQ, LLQ

Nine Regions

Right hypochondriac, epigastric, left hypochondriac, right lumbar, umbilical, left lumbar, right inguinal, hypogastric, and left inguinal

Visceral Pain

Damage or disruption to internal organs and tissues; characterized as vague, poorly localized, dull, achy, burning, or cramping

Parietal Pain

Irritation of the peritoneal lining; easily localized, sharp, constant, severe

Referred pain

Type of visceral pain that is constant and poorly localized

Abdominal assessment sequence

Inspect, auscultate, percuss, and palpate

Abdominal inspection

Skin, color, vascularity, scars, lesions, umbilicus, contour, symmetry, aortic pulsation

Abdominal auscultation

Bowel sounds

Abdominal percussion

Tones over all four quadrants

Abdominal Palpation

Light palpation of all four quadrants

Abdominal contour findings

Flat, rounded, scaphoid, or distended

Hernia

Protrusion of bowel through the abdominal wall

Cullen’s sign

Abnormal finding of bruising coloring around the umbilicus

Grey Turner’s Sign

Abnormal coloration along the flank

Aortic pulsations

Abnormal observation during inspection

Six F’s of Abdominal Distention

Fat, feces, fetus, fibroids, flatulence, fluid

Present/normal bowel sound

Intermittent gurgles, 5-30 per minute

Hypoactive bowel sounds

Diminished bowel motility

Hyperactive bowel sounds

Very rapid motility

Absent bowel sounds

No bowel sounds heard

Percussion sounds

Tympany (hollow organs) and areas of dullness (solid organs)

CVA tenderness

Blunt percussion over the kidneys at the costovertebral angels, over the 12th rib