Next, auscultate the abdomen. Move the stethoscope in a symmetrical pattern,
listening in all four quadrants.
a. Listen for bowel sounds. The best location is below and to the right of the
b. Describe the sounds heard according to location, frequency, and character of
c. Abnormalities include absent bowel sounds and the peristaltic rush of a
After auscultation, palpate the abdomen. Palpation is used to detect muscle
guarding, tenderness, and masses. Gently palpate the abdomen, moving in a
symmetrical pattern and covering all four quadrants. Record any of the following
a. Rigidity or Guarding. This is the inability to relax the abdominal muscles.
(Rigidity may be caused by nervousness or fear. Encourage the patient to breathe
deeply and regularly to promote relaxation.)
b. Pain or Tenderness. Ask the patient to describe the pain if palpation elicits
a painful or tender area.
c. Rebound Pain. This is pain felt upon release of pressure, as opposed to
application of pressure.
d. Masses. Organs can be palpated for size and contour by a trained examiner.
Additionally, masses and irregularities in and around the abdominal organs may be
Section III. DIAGNOSTIC PROCEDURES
a. General. The digestive tract can be outlined by x-rays by utilizing the
administration of a contrast medium. The contrast medium is swallowed by the patient
in order to visualize the upper GI tract. These procedures are referred to as "barium
swallow," "upper GI," or "small bowel follow-through." To visualize the lower GI tract,
the contrast medium is instilled rectally. This procedure is called a "barium enema."