Abdominal (GI) Examination

Introduction0/5

• Greetings
• Hand wash
• Verify the patient's identity using at least two or three details
• Explanation
• Consent

Exposure and positioning0/2

• Lie patient flat with head resting on single pillow
• Expose chest to pubic symphysis

• General AppearanceAssess for jaundice, body habitus (obese or cachexia), mental state

Hands0/6

• Nails
  • Look for nailbedsCheck for leukonychia (sign of hypoalbuminaemia), Terry's nails
  • Finger clubbing
• Palmar creasesCheck for pallor
• Dupuytren's contracture
• Hepatic flap

• ArmsLook for bruising, petechiae, muscle wasting, scratch marks, spider naevi

Face0/4

• EyesCheck sclera for jaundice, conjunctiva for pallor (anaemia), Kayser-Fleischer rings (Wilson's disease), Xanthelasmata
• Salivary glandsInspect and palpate for parotid and submandibular gland enlargement
• MouthCheck teeth, gums, fetor hepaticus, aphthous ulceration, angular stomatitis, candida (thrush)
• TongueLook for leucoplakia, glossitis, geographical tongue

Neck and chest0/4

• Lymph nodes
  • Cervical lymph nodes
  • Supraclavicular nodes
• Chest inspectionLook for spider naevi, gynaecomastia in males

Abdomen0/16

• InspectionCheck for scars, distension, swellings, hernias, caput medusae, pulsations, visible peristalsis, skin lesions, Cullen's and Grey-Turner's sign (acute pancreatitis), striae
• Light palpation
• Deep palpationAssess for guarding, rigidity, and rebound tenderness
• Palpate liverCheck for hepatomegaly
• Palpate spleen
• Palpate gallbladder / Murphy's sign
• Palpate abdominal aorta
• Percussion
  • Liver borders
  • Spleen
  • Bladder
  • Shifting dullnessTo check for ascites
• Auscultation
  • Bowel soundsListen in all 4 quadrants. Absence for 4 mins suggests ileus.
  • Renal and Aortic bruits
• If mass → ask patient to sit halfway up and comment on changesHelps differentiate between intra-abdominal and abdominal wall masses

Groin/rectal0/1

• Examine for inguinal hernias (both lying and standing)

Others (optional / if mentioned in prompt)0/4

• Vital signs
• BSL
• Urinalysis
• Pregnancy test