What are the steps for abdominal physical examination?
Nov 05, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, abdominal physical examination is an important method for clinical assessment of abdominal health. It is primarily conducted through steps including inspection, palpation, percussion, auscultation, and special tests, with each step complementing the others to facilitate a comprehensive understanding of the abdominal condition. During the examination, the patient should remain relaxed and cooperate with respiratory adjustments, while the examiner must perform procedures gently and in accordance with standard protocols to ensure accurate results.
Under normal circumstances, abdominal physical examination is an important clinical method for assessing abdominal health. It is mainly conducted through steps such as inspection, palpation, percussion, auscultation, and special tests. These steps work together to provide a comprehensive understanding of the abdominal condition. A detailed analysis is as follows:
1. **Inspection**: The examiner should observe the shape of the patient's abdomen to determine whether there is distension or depression. The abdominal skin should be examined for rashes, pigmentation, or scars. Attention should also be paid to whether abdominal wall veins are varicose and to the movement of the abdominal wall during respiration, as these findings can provide initial insights into the overall abdominal status.
2. **Palpation**: Begin palpation in the lower left quadrant and proceed gently in a clockwise direction across all abdominal regions. Perform superficial palpation first to assess abdominal wall tension, followed by deep palpation to check for tenderness, rebound tenderness, or any palpable masses. If a mass is detected, its location, size, and consistency should be documented.
3. **Percussion**: Follow the same clockwise pattern, lightly tapping the abdominal wall with fingers. Interpret the sounds obtained—tympanic sounds often indicate gaseous distension of the gastrointestinal tract, while dullness may suggest the presence of ascites. Special attention should be given to percussing the liver and spleen areas to help evaluate whether their sizes are within normal limits.
4. **Auscultation**: Place the stethoscope on the upper, middle, and lower abdomen sequentially. Focus primarily on bowel sounds; normally, these occur 4–5 times per minute. Record both the frequency and intensity of bowel sounds. Hyperactive or hypoactive sounds may indicate abnormal intestinal function.
5. **Special Tests**: Perform specific tests based on clinical suspicion. For example, Murphy’s sign can be tested if biliary disease is suspected; epigastric tenderness may be assessed when pancreatic pathology is considered; and shifting dullness can be checked to further confirm suspected ascites.
Throughout the examination, the patient should remain relaxed and cooperate with breathing adjustments. The examiner must perform procedures gently and according to standard protocols to ensure accurate results. In daily life, maintaining abdominal warmth and avoiding overeating are recommended to support abdominal health.
