ABDOMINAL PHYSICAL EXAM

Instructions: Pick one of the following cases for your HxPxDx Exam write-up

CASE A

A 17 y/o male, named Steven Johnson comes in because he has had “Severe stomach pain” for the past 6 hours.

Vital signs

·  Temp: 103 F, HR: 120, regular, RR: 23, BP: 90/60

·  Pulse-ox: not obtained, Pain: 8/10, Ht:6’1”, Wgt: 210 lbs [use adult BMI measurements]

Abdomen:

·  Pain and tenderness to light and firm palpation in the lower right quadrant.

·  Guarding and rigidity. Rebound tenderness.

·  Abdominal aorta not deeply palpated due to patient’s condition.

·  Negative Murphy’s sign. Positive obturator sign and Rovsing’s sign. Negative psoas sign.

CASE B

A 71 y/o male, named John Stevenson comes in because he has had “Severe stomach pain” for the past 6 hours.

Vital signs

·  Temp: 103 F, HR: 120, regular, RR: 23, BP: 90/60

·  Pulse-ox: not obtained, Pain: 8/10, Ht:6’1”, Wgt: 210 lbs

Abdomen:

·  Pain and tenderness to light and firm palpation in the lower left quadrant.

·  Guarding and rigidity. Rebound tenderness.

·  Abdominal aorta not deeply palpated due to patient’s condition.

·  Negative Murphy’s sign. Negative obturator sign and Rovsing’s sign. Negative psoas sign.