Physical Assessment of the Gastrointestinal System

Walden University

Physical Assessment of the Gastrointestinal System

The examination of the gastrointestinal system is an evaluation of the organs in the center of the body and the associated vasculature and lymphatics. Its functions are investigated by using inspection techniques of visual inspection, palpation (feeling with the hands), percussion (tapping with the fingers), and auscultation (listening). The purpose of this paper is to demonstrate the record of the findings resulting from the gastrointestinal physical assessment of patient Mr. J.

|Week #4 |
|Abdomen |
|Contour/Symmetry | |
| |Visual examination of the abdomen revealed symmetry bilaterally; no skin |
| |abnormalities were found. There were no abdominal masses visible, and the|
| |movement of the abdominal wall with respiration was symmetrical. There |
| |was no scaphold abdomen, distension or bulges visible. There was no |
| |protrusion of abdominal viscera seen through the abdominal opening in the|
| |muscle wall which would indicate a hernia. The abdominal wall moves |
| |posteriorly in a symmetrical fashion with inspiration. There is no |
| |localized or generalized rigidity of the abdominal wall so that this |
| |motion is absent which might indicate peritonitis. There were no enlarged|
| |veins seen. Abnormalities were not detected on visible inspection. |
|Skin | |
| | The surface is smooth and even and warm and moist. There was |
| |no discoloration noted of the skin on visual inspection. There was no |
| |bluish discoloration of the umbilicus (Cullen's sign) or flanks (Grey |
| |Turner's sign) .No striae, or "stretch marks," or surgical scars were |
| |found. There was no redness or jaundice. No glistening or tautness was |
| |found as might have been seen if the patient had ascites. There were no |
| |unusual color or shaped moles. No petechiae and no cutaneous angiomas was|
| |seen as might be if the patient had portal hypertension or liver disease.|
| |No lesions or rashes were seen on examination. There were no visible |
| |veins as might be seen in a visibly thin person. Prominent or dilated |
| |veins are not seen as might be if the patient had portal hypertension, |
| |cirrhosis, ascites, or vena caval obstruction. The skin turgor is |
| |observed to demonstrate rapid snap back to its normal position. There is |
| |no decreased turgor and the skin does not remain elevated or return |
| |slowly to its normal position as might be seen if the patient were |
| |dehydrated. There was no edema evident on examination of the abdominal |
| |skin. |
|Umbilicus | |
| |The umbilicus is midline and inverted, with no sign of discoloration, |
| |inflammation or hernia. There is no eversion which might be found if the |
| |patient had ascites or an underlying mass. The umbilicus is not deeply |
| |sunken as it might be if the patient were obese. There is no bluish |
| |periumbilical color or Cullen sign that might indicate intra-abdominal |
| |bleeding. |
|Pulsations | |
| |Pulsations from the aorta beneath the skin can be seen in the epigastric |
| |area. There is not marked pulsation or widened pulse pressure that might |
| |indicate hypertension, aortic insufficiency, thyrotoxicosis or as might |
| |be seen if the patient had an aortic aneurysm. |
|Bowel/Vascular Sounds | |
| |Auscultation of the abdomen was performed and bowel sounds were detected |
| |in all for quadrants. Bowel sounds are high-pitched, with gurgling and |
| |cascading sounds heard. Neither hypoactive nor hyperactive were heard. |
| |No alteration of bowel sounds, rubs, or vascular bruits were detected. |
| |No bruits or “swishing" sounds were heard over major arteries during |
| |systole or diastole. No bruits were heard on auscultation of the area |
| |over the aorta, or either renal arteries. The iliac arteries were |
| |auscultated and no bruits were found on examination. No rubs were found |
| |on abdominal examination that can occur over the liver, spleen, or an |
| |abdominal mass. No rub was heard as might indicate an irritation of |
| |serosal surfaces. No bruit was heard that might indicate atherosclerosis |
| |or altered arterial blood flow. |
|Tympany/Dullness | |
| |Tympany was predominate on percussion. Dullness was not found over the |
| |bladder as might be if the patient’s was experiencing a distended |
| |bladder. No dullness was found as might indicate a mass. Hyperresonance |
| |was not present as might be if the patient had gaseous distension. |
|Splenic Dullness | |
| |The spleen was located by percussion at the 10th intercostal space, just |
| |behind the left midaxillary line. The area of splenic dullness is not |
| |wider than 6 cm. There was no dullness forward of the midaxillary line |
| |that would indicate spleen enlargement that might be found if the patient|
| |had mononucleosis, trauma or infection. |
|Light Palpation | |
| |No crunching feeling of crepitus of the abdominal wall, a sign of gas or |
| |fluid within the subcutaneous tissues were felt on light palpitation. |
| |Palpation examination of the abdomen revealed no tenderness, or abdominal|
| |masses. The liver and kidneys are palpable, but there were no other |
| |masses felt. Aortic pulsations were easily palpitated in the region of |
| |the upper anterior abdominal wall. The femoral artery pulsations are |
| |easily palpated. |
|Deep Palpation | |
| |Deep and light palpation were used around the area of the outlines of |
| |internal organs including the liver, spleen, kidneys, and aorta, a large |
| |blood vessel. The spleen is not palpable. Neither the right nor left |
| |kidney are palpable. No spasm, rigidity or involuntary tightening of the|
| |abdominal musculature was found to occur on palpation examination as |
| |would be found in response to underlying inflammation. Palpation did not |
| |elicit guarding as would have indicated pain. No rebound tenderness was |
| |found on examination. Palpation did not elicit facial grimace, or spasm |
| |of the abdominal wall. |
| |No intra-abdominal or within the abdominal wall masses were palpated. |
|Abdominal Reflex | |
| |The contraction of the abdominal muscles resulting in deviation of |
| |umbilicus towards the area stimulated was observed as a normal positive |
| |response. An absent response was not seen as might be is the patient were|
| |obese or tolerant or as a might be seen if the patient had multiple |
| |sclerosis, motor neurone disease, neurogenic bladder, Brown-Séquard |
| |syndrome or with Chiari malformations. |
|Groin |
|Skin | |
| |The skin is smooth and intact with no bumps lessons or masses that can be|
| |felt or seen. There was no external bulge in the groin area or |
| |connective tissue felt and no expression of tenderness or pain consistent|
| |with a groin hernia. There are no genital rashes, red spots, brown spots |
| |or white spots in the groin areas or legs. No dark spots or skin chafing |
| |was seen on examination. The skin is not dry and the patient denied pain |
| |or itching. No skin tags or boils were found on examination. |
| | |
| | |
|Femoral Pulse | |
| | The femoral pulse was palpitated to assess for adequacy of the pulse. |
| |The strength of the pulse can be assessed at 2+ bilaterally. |

Summery

The findings of the physical assessment of the examination of the gastrointestinal system reveals the health of the organs of the center of the body. It is the assessment of the core of the human body and its associated vasculature and lymphatics.