Although an essential component of all routine physical examinations, the physical examination of the abdomen is the key step in the evaluation of abdominal complaints such as pain, distension, enlarged organs, or masses.
The examination is conducted in a predetermined sequence starting from observation and then sequentially performing auscultation, palpation, and percussion (see images below) followed by ancillary maneuvers.
However, a vital step in assuring a successful outcome is to properly prepare the challenging patient before anything else is done
The major components of the abdominal exam include: observation, auscultation, percussion, and palpation. While these are the same elements which make up the pulmonary and cardiac exams, they are performed here in a slightly different order (i.e. auscultation before percussion) and carry different degrees of importance. Pelvic, genital, and rectal exams, all part of the abdominal evaluation, are discussed elsewhere.
Think Anatomically: When looking, listening, feeling and percussing imagine what organs live in the area that you are examining. The abdomen is roughly divided into four quadrants: right upper, right lower,
left upper and left lower. By thinking in anatomic terms, you will remind yourself of what resides in a particular quadrant and therefore what might be identifiable during both normal and pathologic states.
