look at your tummy if that’s all right next?
So, on inspection, I’m looking for things
like scars. Is there any distension? Is there
any scratch marks? Is there any bruising?
Bruising around the umbilicus is called Cullen’s
sign, excellent. And any bruising around the
flanks, so you’d have a look at both sides.
Grey-Turner’s sign. Absolutely. So, Grey-Turner’s
with the retroperitoneal bleeding. So you
may think of it as a triple A. It has something
to do with the kidneys. Another thing to look
at is potential scars that go into the flanks
which might indicate --
Yeah. Absolutely, absolutely. I can’t see
anything obvious when I’ve examined you,
Tommy. So, would it be all right for me to
have a very quick feel of your tummy?
Yeah. Okay. It’s an important thing
to get down
to the patient’s level, and I’m keeping
my eyes focused on the patient. Is there any
sore at the moment?
What would you do if there was?
Start away from the area.
Yeah, start away from them. So, I was trying
to think of the light touch as you’re sort
of feeling out for any areas that might be
so -- okay. So I’m just going to start up
here. Just tell me if anything is feeling
sore. So I’m just systematically palpating
all nine quadrants and having a look at the
patient’s face for any signs the discomfort.
That’s all okay, sir?
Would it be alright for me to have a bit of
a deeper feel, Tommy? This time, the deeper
feel is more to feel for masses, pulsations.
Is there anything else obvious that I can
listen such as a deep pain when I’m palpating?
Again, I’d palpate deeply at all nine quadrants.
Things that you need to look for when you’re
palpating is the pain when you’re pushing
in, is it worst when you’re letting go?
That gives you an idea of whether or not there’s
any rebound tenderness. In terms of palpation,
I’m going to move on to just have a quick
feel of your kidneys if that’s okay? So
you just lay back. I’m just going to slip
my hand just behind your back. You relax for
me. I’m just going to press back and forth.
Is that feeling sore at all?
Okay. So you’re feeling for the size of the kidney.
That’s fine. And if it’s enlarged,
you might feel a renal mass, but you’re
also trying to feel if there’s any renal
angle tenderness. Next thing I want to do
is feel out for the liver. How do we do that?