Overview
This lecture covers the proper sequence and important tips for abdominal assessments, focusing on inspection, auscultation techniques, and key findings.
Abdominal Assessment Sequence
- Always begin by inspecting the abdomen.
- Auscultate the abdomen before palpation or percussion to avoid altering bowel sounds.
- Start auscultation in the right lower quadrant where the ileocecal valve is located.
Bowel Sounds Assessment
- The right lower quadrant is the typical origin of bowel sounds due to the ileocecal valve.
- Listen to all quadrants in a clockwise manner after starting at the right lower quadrant.
- Normal bowel sounds: 5–30 sounds per minute.
- Fewer than 5 sounds per minute indicate hypoactive bowel sounds.
- More than 30 sounds per minute indicate hyperactive bowel sounds.
- Absence of bowel sounds is determined if none are heard after 5 minutes of listening.
Specialized Auscultation Technique
- Use the bell of the stethoscope to listen for bruits, which are low-pitched vascular sounds.
Key Terms & Definitions
- Auscultation — Listening to internal body sounds, typically with a stethoscope.
- Ileocecal valve — The valve connecting the small intestine to the large intestine, located in the right lower quadrant.
- Hypoactive bowel sounds — Fewer than 5 bowel sounds per minute.
- Hyperactive bowel sounds — More than 30 bowel sounds per minute.
- Bruit — An abnormal low-pitched sound indicating turbulent blood flow, best heard with the bell of the stethoscope.
Action Items / Next Steps
- Practice performing abdominal assessments using the correct sequence.
- Review the locations of abdominal quadrants and the ileocecal valve.
- Prepare for a quiz on normal and abnormal bowel sound findings.