Gastrointestinal System Assessment (ABDOMEN)

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Anatomy & Physiology of the Gastrointestinal (GI) System

Functions of the GI System

  • Ingestion: Intake of food.

  • Digestion: Breakdown of food (mechanical and chemical).

  • Absorption: Nutrient transfer to the bloodstream.

  • Excretion: Waste elimination via defecation.

Anatomy of the GI System

  • Upper GI Tract: Mouth, pharynx, esophagus, stomach.

  • Lower GI Tract: Small intestine (duodenum, jejunum, ileum), large intestine (colon, rectum, anus).

  • Accessory Organs: Liver, gallbladder, pancreas.

GI System Landmarks for Physical Assessment

  • Four Quadrants:

    • Right Upper Quadrant (RUQ): Liver, gallbladder, right kidney, pancreas head.

    • Left Upper Quadrant (LUQ): Stomach, spleen, left kidney, pancreas body.

    • Right Lower Quadrant (RLQ): Appendix, cecum, right ovary.

    • Left Lower Quadrant (LLQ): Sigmoid colon, left ovary.

<h4 collapsed="false" seolevelmigrated="true"><strong>Functions of the GI System</strong></h4><ul><li><p><strong>Ingestion</strong>: Intake of food.</p></li><li><p><strong>Digestion</strong>: Breakdown of food (mechanical and chemical).</p></li><li><p><strong>Absorption</strong>: Nutrient transfer to the bloodstream.</p></li><li><p><strong>Excretion</strong>: Waste elimination via defecation.</p></li></ul><h4 collapsed="false" seolevelmigrated="true"><strong>Anatomy of the GI System</strong></h4><ul><li><p><strong>Upper GI Tract</strong>: Mouth, pharynx, esophagus, stomach.</p></li><li><p><strong>Lower GI Tract</strong>: Small intestine (duodenum, jejunum, ileum), large intestine (colon, rectum, anus).</p></li><li><p><strong>Accessory Organs</strong>: Liver, gallbladder, pancreas.</p></li></ul><h4 collapsed="false" seolevelmigrated="true"><strong>GI System Landmarks for Physical Assessment</strong></h4><ul><li><p><strong>Four Quadrants</strong>:</p><ul><li><p><strong>Right Upper Quadrant (RUQ)</strong>: Liver, gallbladder, right kidney, pancreas head.</p></li><li><p><strong>Left Upper Quadrant (LUQ)</strong>: Stomach, spleen, left kidney, pancreas body.</p></li><li><p><strong>Right Lower Quadrant (RLQ)</strong>: Appendix, cecum, right ovary.</p></li><li><p><strong>Left Lower Quadrant (LLQ)</strong>: Sigmoid colon, left ovary.</p></li></ul></li></ul>
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<p>Physical Examination Techniques</p>

Physical Examination Techniques

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Key Special Tests

  • Mc Burney’s Point Tenderness → Appendicitis (RLQ pain).

  • Rovsing’s Sign → RLQ pain with LLQ palpation (appendicitis).

  • Fluid Wave Test → Detects ascites.

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Differentiating Normal & Abnormal Findings

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Analyzing Findings from Interviews, General Survey & Physical Exam

Interview Findings:

  • Chief complaints: Abdominal pain is often, bloating, nausea, vomiting, changes in bowel habits.

  • Past history: Surgery, ulcers, hepatitis, gallstones.

  • Dietary habits: High-fat diet, fiber intake.

  • Alcohol & smoking history: Risk for ulcers, liver disease.

General Survey:

  • Skin tone: Jaundice (liver dysfunction), pallor (anemia).

  • Weight loss/gain: Malabsorption (weight loss), fluid retention (ascites).

Physical Exam Analysis:

  • RUQ tenderness + Jaundice → Liver disease, gallbladder disease.

  • RLQ pain + Rebound tenderness → Appendicitis.

  • Distended abdomen + Absent bowel sounds → Bowel obstruction.

  • Black stools + Epigastric pain → GI bleeding, peptic ulcer.

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