Why don't use the cold hand's plam and diaphragm of the stethoscope while performing the abdomen?
Answers
Answer:
Definition
Inspection consists of visual examination of the abdomen with note made of the shape of the abdomen, skin abnormalities, abdominal masses, and the movement of the abdominal wall with respiration. Abnormalities detected on inspection provide clues to intra-abdominal pathology; these are further investigated with auscultation and palpation.
Auscultation of the abdomen is performed for detection of altered bowel sounds, rubs, or vascular bruits. Normal peristalsis creates bowel sounds that may be altered or absent by disease. Irritation of serosal surfaces may produce a sound (rub) as an organ moves against the serosal surface. Atherosclerosis may alter arterial blood flow so that a bruit is produced.
Palpation is the examination of the abdomen for crepitus of the abdominal wall, for any abdominal tenderness, or for abdominal masses. The liver and kidneys may be palpable in normal individuals, but any other masses are abnormal.
Technique
Inspection
The abdomen is inspected by positioning the patient supine on an examining table or bed. The head and knees should be supported with small pillows or folded sheets for comfort and to relax the abdominal wall musculature. The entire abdominal wall must be examined and drapes should be positioned accordingly. The patient's arms should be at the sides and not folded behind the head, as this tenses the abdominal wall. Good lighting is essential, and it is helpful to have tangential lighting available, for this can create subtle shadows of abdominal wall masses.
First, the general contour of the entire abdominal wall is observed. The contour should be checked carefully for distention and note made as to whether any distention is generalized or localized to a portion of the abdomen. Similarly, the flanks should be checked for any bulging.
The abdominal wall skin should be inspected carefully for abnormalities. Any areas of discoloration should be noted, such as the bluish discoloration of the umbilicus (Cullen's sign) or flanks (Grey Turner's sign). The skin should be inspected for striae, or "stretch marks," and surgical scars. Careful note of surgical scars should be made and correlated with the patient's recollection of previous operations. The skin of the abdomen should also be checked carefully for engorged