After this course, you should seek to:

• List and describe key structures of the abdomen (gastrointestinal and other viscera)
• Outline the principal properties, relations and functional interactions of these structures
• Assess their status via case history, observation and appropriate testing
• Demonstrate key psychomotor skills relevant to your examination of the above
• Apply yourself to a novel theoretical clinical situation, demonstrating a synthesis of               abdomen-related knowledge and skills, testing any hypotheses you generate
• Explicitly analyse your diagnostic process, reflecting on its strengths and weaknesses
• Evaluate the bearing of these processes on your subsequent physiotherapeutic care

NB the above may be the subject of formative or summative assessment, in line with prevailing MACP guidelines


References

Visit as many of the references shown below as possible prior to your course. These are drawn from a variety of texts and take a range of forms (pictorial, textual and tabular). Our intention is to provide you with an assortment of information sources that you can choose from - and that you can match to your own learning style.

Detail on context and history leading to examination procedure: Ref 1 pp 186-187

Detailed history: Ref 7 p 260

Clinical examples of relevant signs in the eyes: Ref 4 pp 298-326,

Clinical examples of relevant signs in the nails: Ref 4 p 230 and p 287

Clinical examples of relevant signs in the trunk: Ref 4 pp 228-232.

Bring your own:

Bright pen torch
Tongue depressors
Stethoscope (Littmann type preferable)

Indications: Unexplained abdominal or dorso-lumbar spinal pain
Abnormalities of digestion / defecation
Unexplained weight loss

• Structures involved
Gastrointestinal structures from mouth inwards / downwards
Related viscera of aorta, liver, spleen and kidneys, gastro-intestinal tract
Key surface anatomy of the above

• Observation
What initial information can you gain about the above structures from a patient’s voice, breath, face, skin and overall posture?

• History
We will uncover the significance of dysphagia, dyspepsia, changes in
bowel habit and dietary intolerance. What important questions should be asked about previous medical and family history?

• Systemic ill-health
Just how are other systems affected by dysfunction of the structures under discussion? (For example nervous, musculoskeletal, immunological)

• Specific observation
Learn what you should be looking for in the hands, eyes and body. For instance, what might highly polished nails and scratched skin tell you about abdominal structures and functions?

• ‘Hands - on’ examination
How to conduct an accurate, informed and informative examination of the abdomen and functionally associated structures using your palpatory and other manual skills for improved patient management.

For example: - Is the aorta enlarged? Is that abdominal ‘lump’ normal or abnormal? How do you distinguish between kidney and spleen?

• Altered abdominal / gastrointestinal function - terminology
Record and communicate your findings accurately and succinctly using accepted terms