Local examination of acute abdomen by palpation

 
Local examination of acute abdomen by palpation

Local examination of  the abdomen by palpation unless you are
 left handed always stand by the right  side of the patient during palpation of the abdomen make sure that the abdominal wall is as lax as possible and that your hands are warm tell the patient to bend up the knees and the put a pillow underneath them to take the weight of the legs ask him to open the mouth and
breathe quietly in and out always start your palpation as far away from the painful area as possible and proceed systematically to other regions approaching the affected area last of all thus if the patient ls complaining of pain in the right iliac fossa
starts in the left hypochondrium and proceed to the epigastrium right hypochondrium right lumbar region umbilical region left lumbar region left iliac fossa hypogastrium and finally the affected region first by light or superficial palpation then with deep palpation by light palpation the tone of the muscles is estimated and any superficial tenderness swelling or movement are detected deep palpation is carried out to elicit deep
tenderness or abnormal swelling the hand should laid flat on the abdomen with the metacarpophalangeal joints flexed to bring the pulp and palmar surface of the fingers towards the underlying viscera te hand should be gradually deepened into the abdomen and moved gently to and fro as in pill-rolling in this way any thickened structure or mass will roll under the fingers the spleen kidneys and liver are best palpated bimanually

       

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