Advanced Physical Diagnosis Online Companion

The pleximeter (bottom) and hammer (top) were used by the 18th century Viennese physician Leopold Auenbrugger for his, then new, diagnostic technique of percussing the patient's body

 The central aspect of the assessment of gastrointestinal health lies in the abdominal exam.  However, signs of GI pathology are not limited to the abdomen. As with all aspects of the physical exam we recommend a thorough and systematic approach.  

Begin with observing the overall state of the patient. Does the patient appear jaundiced?  Are the sclera icteric?  Is the belly so full that it inhibits the descent of the diaphragm?  Is there palmar erythema or are there abnormalities in the fingernails?

Next move to the abdominal exam and proceed systematically beginning with auscultation (keeping in mind that auscultating bowel sounds after deep palpation may lead to inaccurate findings).

The Hand in Diagnosis From The Stanford Medicine 25 Website (used with permission)

A re-evaluation of the scratch test for locating the liver edge

Bates' Visual Guide to Physical Examination, Volume 13: Abdomen (9 videos)