ABDOMINAL ASSESSMENT

PARAMETER NORMAL ABNORMAL INDICATION

View abdomen Abdomen Asymmetry Tumors
from different symmetrical Cysts
angles. bilaterally from costal Bowel obstruction
margin to iliac rest w/ Organomegaly or
umbilicus in center Scoliosis
Inspect contour No abdominal With abdominal Causes are “nine F’s”
from various distention distention Fats, fluid, feces,
angles. filatus, fibroid, full
bladder, false
pregnancy & fatal
tumor
Look for On a thin pt. Increase peristaltic Intestinal obstruction
respirations, peristalsis, pulsations waves
pulsations & may be visible. Reverse peristaltic Pyloric stenosis
peristalsis. Women’s respirations waves
are more thoracic, Abnormal respiratory May indicate respiratory
whereas men tend to disease
use their abdominal Increased pulsations
Aortic anuerysm
muscles more with
breathing.
Use the diaphragm Bowel sounds at a Bowel sounds more Hyperactive bowel
portion of the rate of 5-30 than 30 clicks/min. sounds or
stethoscope to clicks/min. in each hyperperistalsis
listen for bowel quadrant
sounds in all four
quadrants.
Percuss the Tympany to dullness, Extremely high- Distention
abdomen in all four depending on pitched tympanic
quadrants. abdominal content sounds
Extensive dullness Organ enlargement
or underlying mass
Perform light Abdomen soft and Areas of tenderness Indicates underlying
palpation & deep nontender problem
palpation. No organomegaly or Masses May indicate
masses, nontender underlying tumor,
enlarged uterus,
feces-filled color
 NEUROLOGICAL ASSESSMENT

PARAMETER NORMAL ABNORMAL INDICATION

Note pt. posture, Well groomed, erect Lack of facial Possible
grooming and posture, pleasant expression/inappropriate psychological
affect. facial expressions, expression for speech disorder (
appropriate affect content depression or
schizophrenia) or
neurologic
impairment
affecting cranial
nerves
Test of Awake, alert, and Disorientation Anxiety, hypoxia,
orientation to oriented to time, fluid and electrolyte
time, place and placeand person imbalance,
person. neurologic problem
Test mental status Immediate, recent, Has difficulty in recalling Alzheimer’s disease
& cognitive and remote memory fast or recent events Forgetfulness
function are intact
(Test immediate
recall, test recent
memory, test long
term memory).
Test abstract Judgment Impaired judgment Dementia, Psychosis
thinking appropriate and
(Judgment, intact
communication) Speech flows easily Impaired spontaneous Cognitive
speech impairment
 PARAMETER NORMAL ABNORMAL INDICATION
CN I – Olfactory Able to identify Loss of sense of smell Anosmia
substance
Ask pt. to identify
substance. Repeat
to other nostrils.
CN II, III, IV, & VI – Visual acuity intact CN II deficits Stroke or brain tumor
Optic, Oculomotor, 20/20 both eyes: CN III deficits Increased ICP
Trochlear & PERRLA direct and Abnormal doll’s eyes CN III, IV, VI are
Abducens nerve consensual. EOM damaged
intact
Test visual acuity
CN V – Trigeminal Pt. perceives light to Inability to perceive Peripheral nerve
nerve touch and superficial light touch and damage
pain bilaterally superficial pain
Testing corneal
reflex
CN VII – Facial Facial nerve intact: Asymmetrical or Bell’s palsy
nerve able to make faces impaired movement Stroke

Ask pt. to perform

smile, frown, and
raise eyebrows.
CN VIII – Acoustic Able to hear sounds Hearing loss Balance disturbance
nerve on both ears Acoustic nerve
damage
Perform Weber &
Rinne tests for
hearing.
CN IX & X – Swallow & cough Unilateral movement Contralateral nerve
Glossopharyngeal reflex intact. damage
and Vagus nerve Speech clear

Assess gag reflex.

CN XI –Accessory Movement Asymmetrical / Peripheral nerve
nerve symmetrical absent movement CN XI damage
Observe for
symmetry of Full ROM of neck
contraction & muscle
strength.
CN XII – Hypoglossal Can protrude tongue Tongue paralysis Dysarthria
nerve medially

Ask pt. to protrude

tongue.