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Abdominal Examination
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the respiratory exam ...
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Medicine
Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, and Health promotion, promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention (medical), prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, medical genetics, genetics, and medical technology to diagnosis (medical), diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, splint (medicine), external splints and traction, medical devices, biologic medical product, biologics, and Radiation (medicine), ionizing radiation, amongst others. Medicine has been practiced since Prehistoric medicine, prehistoric times, and ...
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Epigastrium
In anatomy, the epigastrium (or epigastric region) is the upper central region of the abdomen. It is located between the costal margins and the subcostal plane. Pain may be referred to the epigastrium from damage to structures derived from the foregut. Structure The epigastrium is one of the Quadrants and regions of abdomen#Regions, nine regions of the abdomen, along with the right and left hypochondrium, hypochondria, right and left lateral regions (lumbar areas or flanks), right and left inguinal regions (or fossae), and the umbilical and pubic regions. It is located between the costal margins and the subcostal plane. During breathing, the Thoracic diaphragm, diaphragm contracts and flattens, displacing the viscera and producing an outward movement of the upper abdominal wall (epigastric region). It is a convergence of the diaphragm and the abdominals, so that "when both sets of muscles (diaphragm and abdominals) tense, the epigastrium pushes forward". Therefore, the epigastri ...
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Digital Rectal Exam
Digital rectal examination (DRE), also known as a prostate exam (), is an internal examination of the rectum performed by a healthcare provider. Prior to a 2018 report from the United States Preventive Services Task Force, a digital exam was a common component of annual medical examination for older men, as it was thought to be a reliable screening test for prostate cancer. Usage This examination may be used: * for the diagnosis of prostatic disorders, benign prostatic hyperplasia and the four types of prostatitis. Chronic prostatitis/chronic pelvic pain syndrome, chronic bacterial prostatitis, acute (sudden) bacterial prostatitis, and asymptomatic inflammatory prostatitis. The DRE has a 50% specificity for benign prostatic hyperplasia. Vigorous examination of the prostate in suspected acute prostatitis can lead to seeding of septic emboli and should never be done. Its utility as a screening method for prostate cancer however is not supported by the evidence; * for the eva ...
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Situs Inversus
''Situs inversus'' (also called ''situs transversus'' or ''oppositus'') is a Congenital disorder, congenital condition in which the major Organ (anatomy), visceral organs are reversed or mirror image, mirrored from their normal positions. The normal arrangement of internal organs is known as ''situs solitus''. Although cardiac problems are more common, many people with ''situs inversus'' have no medical symptoms or complications resulting from the condition, and until the advent of modern medicine, it was usually undiagnosed. ''Situs inversus'' is found in about 0.01% of the population, or about 1 person in 10,000. In the most common situation, ''situs inversus totalis'', it involves complete transposition (right to left reversal) of all of the viscera. The heart is not in its usual position in the left chest, but is on the right, a condition known as ''dextrocardia'' (). Because the relationship between the organs is not changed, most people with ''situs inversus'' have no associa ...
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Costal Margin
The costal margin, also known as the costal arch, is the lower edge of the chest (thorax) formed by the bottom edge of the rib cage. Structure The costal margin is the medial margin formed by the cartilages of the seventh to tenth ribs. It attaches to the body and xiphoid process of the sternum. The thoracic diaphragm attaches to the costal margin. The costal angle is the angle between the left and right costal margins where they join the sternum. Function The costal margins somewhat protect the higher abdominal organs, such as the liver. Clinical significance The costal margin may be used for tissue harvesting of cartilage for use elsewhere in the body, such as to treat microtia. Different abdominal organs may be palpated just below the costal margin, such as the liver on the right side of the body. Pain across the costal margin is most commonly caused by costochondritis. The costal paradox, also known as Hoover's sign and the costal margin paradox, is a sign ...
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Feces
Feces (also known as faeces American and British English spelling differences#ae and oe, or fæces; : faex) are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the large intestine. Feces contain a relatively small amount of metabolic waste products such as bacterially-altered bilirubin and dead epithelial cells from the lining of the gut. Feces are discharged through the anus or cloaca during defecation. Feces can be used as fertilizer or soil conditioner in agriculture. They can also be burned as dry animal dung fuel, fuel or dried and used for wattle and daub, construction. Some medicinal uses have been found. In the case of human feces, fecal transplants or fecal bacteriotherapy are in use. Urine and feces together are called excretion, excreta. Characteristics The distinctive odor of feces is due to skatole, and thiols (sulfur-containing compounds), as well as amines and carboxylic acids. Sk ...
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Ovarian Tumor
Ovarian tumors, or ovarian neoplasms, are tumors in the ovary. Not all are ovarian cancer. They consist of mainly solid tissue, while ovarian cysts contain fluid. In 2020, the World Health Organization (WHO) divided ovarian tumours as 90% epithelial, 3% germ cell, and 2% sex cord-stromal types. Histopathologic classification Tumor of the ovary vary remarkably as they may arise from any of the 3 cell types of the normal ovary. Ovarian tumors are classified according to the histology of the tumor, obtained in a pathology report. Histology dictates many aspects of clinical treatment, management, and prognosis. The most common forms are: ''Mixed tumors'' contain elements of more than one of the above classes of tumor histology. History An 1882 article appearing in Scientific American mentions the case of a patient at University of Pennsylvania The University of Pennsylvania (Penn or UPenn) is a Private university, private Ivy League research university in Phi ...
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Traube's Space
Traube's (semilunar) space is an anatomic space of some clinical importance. It is a crescent-shaped space, encompassed by the lower edge of the left lung, the anterior border of the spleen, the left costal margin and the inferior margin of the left lobe of the liver. Thus, its surface markings are respectively the left sixth rib superiorly, the left mid axillary line laterally, and the left costal margin inferiorly. Percussion for splenomegaly The normal human spleen measures about 125 millimeters in length, and splenomegaly is an important clinical sign. There are 2 possibilities to evaluate splenomegaly in the clinical examination: percussion and palpation. Percussion can be done in this space. Beneath Traube's space lies the stomach, which produces a tympanic sound on percussion. Dullness to percussion over Traube's space may indicate splenomegaly, although this can also be a normal finding after a meal or may indicate certain pathologies, e.g. enlarged left lobe of the liver, ...
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Castell's Sign
Castell's sign is a medical sign assessed to evaluate splenomegaly and typically part of an abdominal examination. It is an alternative physical examination maneuver to percussion over Traube's space. Splenomegaly, although associated with numerous diseases, remains one of the more elusive physical exam findings in the abdomen. Conditions such as infectious mononucleosis, thalassemia, and cirrhotic liver disease may all involve splenomegaly and as a result, the search for a reliable sign associated with this condition has been sought for generations. Currently, several such signs of splenomegaly exist, all of whose utility has been debated in medical literature. The presence or absence of splenomegaly, however, can be reliably appreciated on physical exam using Castell's sign in conjunction with other clinical information, increasing the positive predictive value of the test. When used in a decision-making rubric, Castell's sign becomes a valuable part of deciding whether to ...
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Urinary Retention
Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include urinary incontinence, loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections. Causes include blockage of the urethra, nerve problems, certain medications, and weak bladder muscles. Blockage can be caused by benign prostatic hyperplasia (BPH), urethral strictures, bladder stones, a cystocele, constipation, or tumors. Nerve problems can occur from diabetes, trauma, spinal cord injury, spinal cord problems, stroke, or heavy metal poisoning. Medications that can cause problems include anticholinergics, antihistamines, tricyclic antidepressants, cyclobenzaprine, diazepam, nonsteroidal anti-inflammatory drugs (NSAID), stimulants, and opioids. Diagnosis is typically ba ...
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Hepatomegaly
Hepatomegaly is enlargement of the liver. It is a non-specific sign (medicine), medical sign, having many causes, which can broadly be broken down into infection, hepatic tumours, and metabolic disorder. Often, hepatomegaly presents as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice. Signs and symptoms The patient may experience many symptoms, including weight loss, poor appetite, and lethargy; jaundice and bruising may also be present. Causes Among the causes of hepatomegaly are the following: Infective Mechanism The mechanism of hepatomegaly consists of Blood vessel, vascular swelling, inflammation (infectious in origin), and deposition of (1) non-hepatic cells or (2) increased cell contents (such as that due to iron in hemochromatosis or hemosiderosis and fat in fatty liver disease). Diagnosis Suspicion of hepatomegaly indicates a thorough medical history and Abdominal examination, physical examination, wherein the latter typicall ...
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Splenomegaly
Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of ''hypersplenism'' which include: some reduction in number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any combination; a compensatory proliferative response in the bone marrow; and the potential for correction of these abnormalities by splenectomy. Splenomegaly is usually associated with increased workload (such as in hemolytic anemias), which suggests that it is a response to hyperfunction. It is therefore not surprising that splenomegaly is associated with any disease process that involves abnormal red blood cells being destroyed in the spleen. Other common causes include congestion due to portal hypertension and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen, along with caput medusae, is an important sign of portal hypertension ...
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