文档介绍：Abdominal Examination
Xue Huiping
Introduction
It is well known that advances in scientific medicine have occasionally threatened to displace the history and physical examination in the evaluation of the patient. However, we usually discover that technologic advances serve to make the physical examination more rational and provide new understanding or objective documentation of long-appreciated physical finding.
New techniques for evaluation of the intra-abdominal contents include many biochemical, isotopic, ultrasonic, and angiographic methods. These advances, although improving our ability to detect, document, and interpret physical findings, have not superseded the need for the skills of the medical interview and physical examination. An orderly approach to the examination of the abdomen will make possible the analysis of the symptoms arising from the ans of the digestive and genitourinary systems found in this region.
Palpation is an important step in abdominal examination and is difficult to learn, esp. the palpation of the liver and spleen, so we must practise more.
We conform to the same basic steps of inspection, palpation, percussion, and auscultation used in this area as in other areas.
anatomy
There have been several systems or methods devised for dividing the abdomen into topographic segments, but two kinds monly used systems or methods will be described here. Other methods may be found in any standard textbook of anatomy.
Before you understand these two methods, at first you should know the following anatomic landmarks(Figure 1) :
— xiphoid (ensiform) process(剑状突起) of sternum(胸骨) — costal margin肋弓缘 — umbilicus脐 — anterosuperior iliac spine/ anterior superior iliac spine髂前上棘 — iliac crest髂骨嵴 — inguinal ligament 腹股沟韧带