July 6, 2025
How to Perform an Accurate Abdominal Exam
The abdominal exam is one of the most tested and essential parts of the clinical OSCE. Yet many students either rush through it or forget the clinical reasoning behind each step. This article gives you a simplified, high-yield guide that’s perfect for both exams and real-life patients.
🚶 Step-by-Step Guide
1. Inspection (Look)
- General appearance: Is the patient in pain?
- Abdominal symmetry, scars, distension, visible peristalsis
Tip: Observe from the foot of the bed + the side.
2. Auscultation (Listen)
- Bowel sounds: use diaphragm, listen in all 4 quadrants
- Bruits: aorta, renal, iliac, femoral arteries
Listen at least 15–30 seconds per area.
3. Percussion (Tap)
- Percuss all quadrants
- Identify:
- Tympany (air-filled)
- Dullness (fluid, mass)
Shifting dullness? Think ascites.
4. Palpation (Feel)
- Light palpation: check for tenderness or guarding
- Deep palpation: masses, organomegaly
- Rebound tenderness: for peritonitis
Use warm hands, and ask for pain before touching.
