Examination Techniques

Techniques

The techniques of physical examination are in themselves simple, and easy to master. All that is necessary is that you observe carefully, pay attention to detail, and practise repeatedly.

Physicians do vary in their techniques of examination. Shown here are a single set of techniques which are both simple to employ and reliable. Your tutors may however make use of slightly different techniques themselves. We suggest that, initially at least, you learn to use the techniques shown here confidently, so as not to become confused.

Practice

Practice of your examination technique is essential, and you need to see as many patients who demonstrate abnormal physical signs as possible so that you can learn to recognise them.

During this presentation, we shall demonstrate the following:

• Preparing the patient for the examination
• Looking for some signs of abdominal disease on a focused “general” examination
• Inspecting the abdomen
• Light palpation for areas of tenderness
• Detecting peritonism
• Determining the position and size of the liver by percussion and palpation
• Determining the position and size of the spleen by percussion and palpation
• Confirming the presence of ascites
• Other features of portal hypertension
• Examining the iliac fossae and suprapubic region
• Detecting enlarged kidneys
• Identifying other abdominal masses
• Listening for bowel sounds