Abdomen - Inspection, Auscultation, Percussion, and Palpation

Patient Position

Patient should be lying supine.

Abdominal Assessment Order

Inspect, auscultate, percuss, palpate. Remember IAPP.

Abdominal Symptoms

Ask about abdominal pain, dysphagia, flatulence, heartburn, cramping, nausea, and vomiting.

Bowel Patterns

Ask about frequency, character, diarrhea, constipation, and stool color.

Abdominal Appearance

Inspect contour, visible masses, pulsations, and distention.

Abdominal Skin

Inspect for scars, striae, and lesions.

Umbilicus

Inspect contour and assess for umbilical or inguinal hernias.

Bowel Sounds

Listen in all four abdominal quadrants using the diaphragm.

Bowel Sound Quadrants

RUQ, LUQ, RLQ, and LLQ.

Abdominal Percussion

Percuss all four quadrants for tympany and dullness.

Tympany

A high-pitched, drumlike sound caused by air. Expected over most of the abdomen.

Dullness

A softer, thud-like sound expected over organs and solid masses.

Light Palpation

Palpate all four quadrants gently to assess tenderness, guarding, and superficial masses.

Deep Palpation

Palpate all four quadrants more deeply to assess deeper masses and tenderness.

Guarding

Involuntary or voluntary tightening of abdominal muscles during palpation.

Rigidity

Abnormally stiff or boardlike abdominal muscles.

Normal Abdominal Findings

Abdomen is soft, nondistended, and symmetric. Bowel sounds are present in all four quadrants. Tympany noted with percussion. No tenderness, guarding, rigidity, masses, rashes, lesions, or scarring.