文档介绍：8/7/12 Geriatric Assessment: Abdominal and Rectal Examination (printer-friendly)
Geriatric Assessment: Abdominal and Rectal Examination
Mark E. Williams, MD
Posted: 08/02/2012
The Geriatric Abdominal and Rectal Examination
Overview and General Inspection of the Abdomen
We instinctively shield our abdomen when we are physically threatened, and we may feel vulnerable when someone
puts his or her hand on our bare abdomen. Therefore, with an abdominal examination the patient directly experiences
the skill and attentiveness of the examiner.
Positioning the Patient for an Examination
The examination should be done in a warm room with a good light. The patient should be supine with the arms at the
side or over the chest but not behind the head, because this creates tension in the abdominal muscles. Support the
head so that the abdomen is relaxed. Drape the groin with a simple sheet. Once the position is established, explain
what you are going to do at each step of the examination.
Special circumstances require modification. If the patient has kyphosis, use extra pillows. Also, modify the position
upward as needed if the patient has dyspnea from congestive heart failure. A wheelchair-bound patient, a patient with
severe congestive heart failure, or a patient with back injury may not be able to lie flat. Under these circumstances,
you may have