PEMERIKSAAN FISIK ABDOMEN

Nursing UMY

14 Feb 202117:36

Summary

TLDRIn this educational video, a medical professional named Azizah conducts a physical examination of the abdomen. She explains the procedure, which includes inspecting for any abnormalities, auscultating for bowel sounds, and performing percussion to detect organ status and ascites. The examination also involves palpation to assess the liver, spleen, and kidneys, ensuring the patient's comfort throughout. The video serves as a practical guide for medical students and professionals, highlighting the importance of a systematic approach in abdominal examinations.

Takeaways

😀 The script is a detailed account of a physical examination of the abdomen, conducted by a medical professional named Azizah.
🕵️‍♂️ The examination is intended to identify any abnormalities or discomfort in the patient's abdomen, following the patient's complaint of pain.
⏱ The process is expected to take approximately 10 minutes, as mentioned in the script.
👕 The patient is asked to expose the abdominal area by lifting their shirt for the examination.
🔍 The abdomen is divided into quadrants for systematic inspection, which includes observing for any movements, wounds, skin color, or hair distribution.
👂 Auscultation is performed to listen for bowel sounds, with the expectation of hearing them 5 to 35 times per minute.
👊 Percussion is used to determine the presence of air or organs in the abdominal area, with different sounds indicating various conditions.
🤲 Palpation is conducted gently to assess the texture and any tenderness in the abdominal region, with specific attention given to the liver and spleen.
🩺 The script describes a methodical approach to examining for ascites, which includes shifting the patient's position to observe changes in sound during percussion.
🧪 The examination concludes with a check for the presence of any masses or fullness in the abdominal area, and a check for aortic pulsation.
📝 The script emphasizes the importance of a systematic approach to abdominal examination, with inspection, auscultation, percussion, and palpation being the key steps.

Q & A

What is the purpose of the physical examination described in the script?
-The purpose of the physical examination is to determine if there are any abnormalities in the abdominal area of the patient, as the patient had complained of abdominal pain the previous day.
How long is the physical examination expected to take?
-The physical examination is expected to take approximately 10 minutes.
What is the first step in the examination process as described in the script?
-The first step in the examination process is to have the patient expose the abdominal area by lifting the shirt and to ensure the patient is comfortable and lying down.
How is the abdominal area divided for inspection in the script?
-The abdominal area is divided into four quadrants by drawing a horizontal line across the abdomen and a vertical line from the sternum to the pubis, creating the right upper, left upper, right lower, and left lower quadrants.
What is the significance of observing the movement of the abdominal area during the examination?
-Observing the movement of the abdominal area helps to assess the presence of any swelling, pulsations, or asymmetry that may indicate an underlying issue.
What does the script mention about the patient's last meal before the examination?
-The patient had their last meal in the morning, a few hours before the examination.
What is auscultation and why is it performed during the abdominal examination?
-Auscultation is the act of listening to sounds within the body, such as bowel sounds, to detect any abnormalities. It is performed to listen to the sounds produced by the intestines and to count the frequency of bowel sounds, which can indicate the presence of bowel obstruction or other issues.
What is the significance of percussing the abdomen during the examination?
-Percussion is used to determine the presence of fluid or air in the abdominal cavity by listening to the sound produced. It helps to identify the location of organs and detect conditions like ascites or organ enlargement.
How is the liver examined for percussion in the script?
-The liver is examined by percussing from the lower edge of the ribcage towards the pelvis, listening for a change in sound from dull (indicating a solid organ) to resonant (indicating air in the stomach).
What is palpation and how is it performed in the abdominal examination?
-Palpation is the process of examining the abdomen by touch, feeling for tenderness, masses, or organ enlargement. It is performed gently with the fingertips, starting from the non-dominant hand and moving to the dominant hand for deeper palpation.
What is the final step in the abdominal examination as described in the script?
-The final step in the abdominal examination is to palpate the aorta and the kidneys, assessing for any tenderness or abnormalities.

Outlines

00:00

🧑‍⚕️ Abdominal Examination Introduction

The paragraph introduces a medical professional, Azizah, who is about to conduct a physical examination of the abdomen. The examination is to determine if there are any abnormalities in the patient's abdominal area. The patient had previously complained of abdominal pain. The process will take approximately 10 minutes, and the patient is asked to lie down and expose the abdominal area for inspection. The professional also ensures privacy by closing curtains and doors before beginning the examination.

05:02

🔍 Initial Abdominal Inspection

This section describes the initial visual inspection of the patient's abdomen. The medical professional divides the abdomen into four quadrants (right upper, left upper, right lower, left lower) and further into nine regions for detailed examination. The professional observes for any movements, skin color, presence of wounds, hair distribution, and potential hernias around the umbilical area. The symmetry and movement of the abdomen during respiration are also assessed to identify any abnormalities.

10:06

👂 Auscultation and Percussion of the Abdomen

The medical professional proceeds with auscultation to listen to the bowel sounds and other noises within the abdomen. The normal range of bowel sounds is noted to be between 5 and 35 times per minute. Percussion is then performed to determine the presence of air or organs by tapping on different areas of the abdomen. The sounds produced are described as tympanic, resonant, or dull, depending on the area. The professional also checks for any fluid shifts that might indicate the presence of ascites by changing the patient's position and repeating the percussion.

15:08

🤲 Palpation and Further Abdominal Examination

The final part of the examination involves palpation, where the medical professional gently presses on various areas of the abdomen to feel for any abnormalities such as tenderness, masses, or organomegaly. The patient is asked to change positions to assist in detecting fluid movement. The palpation includes checking for the liver, spleen, kidneys, and aortic pulsation. The professional is attentive to the patient's comfort and reactions, ensuring the examination is conducted with care. The paragraph concludes with the professional thanking the patient for their cooperation and summarizing that the examination did not appear to cause any pain.

Mindmap

Keywords

💡Pemeriksaan Fisik

Physical examination is a key concept in the video, referring to the clinical assessment of a patient's health status through observation, auscultation, percussion, and palpation. In the context of the video, it specifically relates to the examination of the abdomen, which is crucial for identifying any abnormalities or disorders. The script mentions various steps involved in this process, such as inspecting the abdomen, listening for bowel sounds, and performing percussion to assess organ status.

💡Quadrant

In the script, the abdomen is divided into quadrants for systematic examination. This methodical approach allows the healthcare provider to thoroughly inspect each section of the abdomen. Quadrants are defined by drawing horizontal and vertical lines through the abdomen, creating four areas: right upper, left upper, right lower, and left lower. This division is essential for pinpointing the location of any pain or abnormalities mentioned by the patient.

💡Auskultasi

Auskultasi, or auscultation, is a diagnostic procedure that involves listening to the internal sounds of the body, such as the sounds of the bowels or blood flow. In the video, auscultation is used to listen to bowel sounds, which can provide clues about the digestive system's function. The script describes listening for sounds that could indicate normal activity or potential issues, such as the frequency and quality of the sounds heard.

💡Perkusi

Perkusi, or percussion, is a technique used in physical examinations where the healthcare provider taps on the body with a finger or an instrument to assess underlying structures. In the video, percussion is used to determine the presence of air or fluid in the abdomen, which can indicate conditions like emphysema or ascites. The script describes the different sounds produced by percussion, such as 'timpani' for air-filled spaces and 'resonant' for solid organs.

💡Palpasi

Palpasi, or palpation, involves the use of touch to examine the body for abnormalities. In the video, palpation is used to feel for tenderness, masses, or organ enlargement in the abdomen. The healthcare provider uses gentle pressure to assess the liver, spleen, and other organs, as described in the script. This technique is crucial for detecting any irregularities that might not be visible or audible.

💡Asam dan Basis Metabolik

While not explicitly mentioned in the script, the examination of the abdomen can indirectly relate to the assessment of a patient's acid-base balance, which is crucial for understanding their metabolic state. The script describes various examinations that could indirectly indicate metabolic issues, such as the presence of ascites, which can be associated with liver disease affecting metabolic processes.

💡Hepatitis

Hepatitis refers to inflammation of the liver, which can be caused by various factors including viral infections. In the video, the healthcare provider performs a liver examination, which includes palpation to assess for any enlargement or tenderness that might indicate hepatitis. The script mentions specific techniques for palpating the liver and the importance of gentle touch to avoid causing discomfort.

💡Splenomegaly

Splenomegaly is the enlargement of the spleen, which can be a sign of various diseases or conditions. The script describes the process of palpating the spleen to check for this condition. Enlargement of the spleen can be felt during the examination, and the script mentions the importance of noting any discomfort or resistance the patient might experience during palpation.

💡Ascites

Ascites refers to the abnormal accumulation of fluid in the abdominal cavity. The script describes a method for detecting ascites through percussion, where the sound changes from 'timpani' to 'dull' or 'resonant' if fluid is present. This is an important diagnostic step because ascites can indicate serious underlying conditions such as liver disease or heart failure.

💡Umbilical Hernia

An umbilical hernia is a protrusion of abdominal contents through the umbilical ring. The script mentions inspecting the umbilical area for any signs of hernia, which could present as a visible or palpable bulge. Identifying a hernia is important as it may require medical intervention to prevent complications such as incarceration or strangulation.

💡Aortic Aneurysm

Although not directly mentioned in the script, the examination of the abdomen includes palpation and auscultation of the aorta, which can help detect an aortic aneurysm. An aneurysm is a bulging or weakening of the aortic wall, which can be life-threatening if it ruptures. The script describes listening for aortic pulsations and palpating the area over the aortic region, which are part of the routine checks for aortic health.

Highlights

Introduction of the physical examination process for the abdomen.

Explanation of the purpose of the examination to identify any disturbances in the abdomen.

Consent and readiness confirmation from the patient before starting the examination.

Instructions for the patient to assume a comfortable position for the examination.

Preparation for the examination by ensuring the patient's cleanliness and privacy.

Division of the abdomen into quadrants for systematic inspection.

Observation of abdominal movements, such as respiratory movements, for any abnormalities.

Inspection for skin conditions, hair distribution, and the presence of any wounds or hernias.

Assessment of symmetry and movement in the abdominal region during respiration.

Auscultation of bowel sounds to determine the frequency and quality.

Use of a stethoscope to listen to the sounds in different areas of the abdomen.

Palpation technique demonstration to check for organ tenderness or masses.

Explanation of the percussion method to identify the presence of air or fluid in the abdomen.

Demonstration of the technique to detect the liver's edge and size through percussion.

Percussion method to determine the presence of ascites or fluid accumulation in the abdomen.

Palpation of the spleen to assess its size and any tenderness.

Kidney palpation technique to check for any abnormalities.

Assessment of the aortic pulsation in the epigastric region.

Conclusion of the physical examination with a summary of findings and patient feedback.

Emphasis on the importance of the examination sequence and the methodical approach to abdominal examination.