MEDiscuss • Clinical Medicine - General • Abdominal Examination - Auscultation

The classical format for examination is Inspection > Palpation > Percussion > Auscultation. However, I was taught today that in abdominal examination, the format is Inspection > Auscultation > Palpation > Percussion.

Can u pls tell which is correct and why?

You are right, the classical format is Inspection > Palpation > Percussion > Auscultation.

But there is a drawback in that sequence. Palpation and percussion usually stimulate and alter the peristaltic movement of the intestines. By auscultating before palpation and percussion, we avoid this alteration and will be able to identify the true basal peristaltic pattern.

Hence, there is "sound" logic in the second sequence where auscultation precedes palpation and percussion.

Nice "sound" logic

Originally Posted by Shashikiran

Palpation and percussion usually stimulate and alter the peristaltic movement of the intestines. By auscultating before palpation and percussion, we avoid this alteration and will be able to identify the true basal peristaltic pattern.

I've never considered this myself but it does seem sound logic as you say.

I think it's probably easier (at least in earlier stages) to remember the usual Inspect > Palpate > Percuss > Auscultate pattern and use it as a solid guide for all examinations but makes more clinical sense to do what you were taught for abdo. Don't think you'd get marked down for doing it the 'classical' way however.