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Abdominal Examination - OSCE Guide (Latest) | UKMLA | CPSA | PLAB 2
Geeky Medics
Overview
This video provides a comprehensive guide to performing an abdominal examination, commonly encountered in OSCE (Objective Structured Clinical Examination) scenarios for medical students and professionals. It demonstrates the systematic approach required, starting with general inspection of the patient, including hands, face, and neck, before focusing on the abdomen itself. The examination progresses through inspection, palpation (both light and deep), percussion, and auscultation of the abdomen. The video emphasizes patient comfort and communication throughout the process, explaining each step to the patient. It concludes with a summary of findings and mentions further steps like examining hernial orifices and performing a digital rectal exam if indicated, highlighting the importance of a thorough and complete examination.
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Chapters
- •Introduce yourself and confirm patient identity (name and date of birth).
- •Explain the procedure and obtain informed consent.
- •Inquire about any pain or discomfort.
- •Ask if the patient has any questions.
- •Inspect hands for signs of liver disease (e.g., palmar erythema, Dupuytren's contractures).
- •Check fingernails for clubbing or koilonychia.
- •Examine the face for jaundice or pallor.
- •Inspect the neck for lymphadenopathy.
- •Position the patient supine with the bed lowered.
- •Ensure the abdomen is adequately exposed.
- •Inspect the abdomen for distension, scars, striae, pulsations, or hernias.
- •Start with light palpation in all four quadrants.
- •Assess for tenderness, guarding, or superficial masses.
- •Proceed to deep palpation to assess for deeper masses or organomegaly.
- •Palpate the liver and spleen if indicated.
- •Percuss all four quadrants to assess for tympany or dullness.
- •Dullness may indicate fluid or masses.
- •Tympany is normal due to gas in the bowel.
- •Listen to bowel sounds in all four quadrants using a stethoscope.
- •Assess for normal, hyperactive, or absent bowel sounds.
- •Listen for bruits over the aorta and renal arteries.
- •Summarize the findings of the abdominal examination.
- •Mention any further examinations that may be indicated (e.g., hernial orifices, DRE, genitalia).
- •Thank the patient and allow them to get dressed.
Key Takeaways
- 1Always introduce yourself, confirm patient identity, and obtain informed consent before starting any examination.
- 2A systematic approach (inspection, palpation, percussion, auscultation) is crucial for a thorough abdominal exam.
- 3General inspection of the patient, including hands, face, and neck, can reveal important clues about underlying conditions.
- 4Patient comfort and communication are paramount; explain each step and check for pain throughout the exam.
- 5Differentiate between light and deep palpation to assess superficial and deeper abdominal structures.
- 6Percussion helps identify abnormalities in abdominal contents, such as fluid or masses.
- 7Auscultation of bowel sounds provides information about gastrointestinal motility.
- 8A complete examination includes considering further steps like examining hernial orifices and performing a digital rectal exam when appropriate.