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Light (superficial, tentative) palpation.

Muscular tonus of the anterior abdominal wall; the stomach soft, is painless, local tenderness, tension in the abdominal wall, presence of the muscular defense (muscle guarding, źdėfense musculaire╗), swelling; symptoms of irritation of the peritoneum (Shchetkin-Blumberg symptom); tumour of the abdominal wall (site (localization), size, form, contours, consistency, tenderness), midline hernia.

Deep sliding methodical (topographical) bimanual palpation accoding to V.P.Obraztsov and N.D.Strazhesko.

Research of bodies of a belly cavity to lead (carry out) strictly consistently, in such order.

Palpation: the sigmoid, the caecum with the appendix, pars coecalis ilii, the ascending and descending colon, the stomach with its part, the transverse colon, the liver, the spleen, the duodenum, the pancreas, the kidneys: physical qualities of each of them separately: form (cylinder, ˛ ŠÓ etc.), size (length, width in cm), surface (smooth, tuberous), consistency (elastic, soft, flabby, firm, hard), tenderness (painless, sensitive, painful), mobility, rumbling sound.

The greater curvature of the stomach: position (on how many than cm above or lower navel), surface, consistency, mobility, morbidity; to compare to the data of definition by the splashing sound of V.P.Obraztsov.

Auscultation: bowel sounds.

Percussion of the liver:

 

Lines The upper border The lower border
right anterior axillary line    
right midclavicular    
right parasternal    
anterior median    
left parasternal    

 

Palpation of the liver, on how many cm protrude above the costal margin on right midclavicular line, anterior median line (left lobe of liver), the form of liver edge (sharp, rounded, rough), surface (smooth, tuberous), consistency (flexible (elastic), soft, firm, hard), tenderness.

Ballottement liver at palpation in the presence of ascites.

Percussion of the spleen:

superior border anterior border

lower border.

Palpation of the spleen: on how many cm protrude above the costal margin, surface, consistency, sensitivity.

Palpation of the kidneys (in horizontal and vertical positions): shape, size and thickness of the lower pole (of right, left kidney), surface (smooth or tuberous), consistency, mobility, tenderness.

 


Date: 2015-01-02; view: 1530


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