Female abdominal examination

Most abdominal examinations for female friends require examinations of intestinal motility, vascular bruits and abdominal wall veins. These are some of the more common abdominal examination items, but if an abdominal examination is needed due to gynecological problems, it should also include gynecological examinations, such as examinations of the vagina, cervix and uterus, so that the cause of one's illness can be fully determined.

Abdominal shape: The normal abdomen is flat and symmetrical. Diffuse abdominal distension is seen in ascites, flatulence or giant ovarian cysts. Localized distension is seen in masses or enlarged organs. Abdominal depression like a boat is seen in cachexia and severe dehydration. Localized depression is seen in surgical scar contraction.

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Abdominal respiratory movement: Men and children mainly breathe abdominally; normal people have free abdominal breathing movements; weakened abdominal respiratory movements are seen in peritonitis, ascites, acute abdominal pain, huge tumors in the abdominal cavity or pregnancy, and disappeared abdominal respiratory movements are seen in acute peritonitis or diaphragmatic paralysis.

·Abdominal wall veins: They are usually not visible in normal people. Distended abdominal wall veins are seen in cirrhosis and obstruction of the superior and inferior vena cava. They can be identified by the direction of blood flow.

Gastrointestinal pattern and gastrointestinal peristaltic waves: Normal people generally do not see gastrointestinal peristaltic waves; patients with pyloric obstruction may see gastric pattern or gastric peristaltic waves in the upper abdomen; patients with intestinal obstruction may see intestinal pattern or intestinal peristaltic waves

Upper abdominal pulsation: seen in normal thin people; pathological conditions seen in abdominal aortic aneurysm, right ventricular hypertrophy, hepatic hemangioma

Other abdominal wall conditions: rashes, pigmentation, striae, scars, hernias, umbilicus and abdominal hair

·auscultation

Bowel sounds: Normal bowel sounds are 4-5 times/minute; bowel sounds are active if they exceed 10 times/minute, and they are accompanied by loud, high-pitched, metallic sounds, which are hyperactive bowel sounds; bowel sounds are less than normal, which are weakened bowel sounds; if bowel sounds are not heard after 3-5 minutes of continuous auscultation, and there are still no bowel sounds when the abdomen is stimulated, it is absent bowel sounds; therefore, auscultation is required to last at least 3-5 minutes

Vascular murmurs: A systolic murmur may be heard in abdominal aortic aneurysm; a systolic blowing murmur may be heard around the navel in renal artery stenosis; a systolic blowing murmur may be heard in liver cancer mass compressing the hepatic artery or abdominal aorta; a continuous venous hum may be heard in the distended veins of the abdominal wall.

Friction sound: Splenic infarction, hepatosplenomegaly, friction sound can be heard in the corresponding parts during deep inspiration

· Scratching sound: can help determine the lower edge of the liver, trace ascites and dilated stomach border

Percussion

Distribution of abdominal percussion sounds

Liver percussion: (1) Percussion of the upper border of the liver: Percuss from top to bottom between the intercostals along the right clavicular midline. The change of the percussion sound from clear to dull indicates the upper border of the liver. In normal people, the liver dullness area is located in the 5th intercostal space, and the normal area (right midclavicular line) is 9-11 cm. When touching the lower edge of the liver, the upper border of the liver should be tapped to determine whether the liver is truly enlarged. (2) Percussion of the lower border of the liver: The lower border of the liver overlaps with hollow organs such as the colon and stomach, and the accuracy of percussion is poor. (3) Pain in the liver area: can be seen in liver abscess and hepatitis