Abdominal Movement
November 26th, 2019
Paradoxical Respiration
Normally, the abdomen moves outward on inspiration and inward on expiration.
Paradoxical movement of the abdomen - inward on inspiration and outward on expiration - is suggestive of diaphragmatic paralysis or fatigue.
Causes of Paradoxical Respiration
- Diaphragmatic paralysis - unilateral or bilateral
- Fatigue - respiratory failure, neuromuscular disease
Abdominal Pulsation
Look For
- An obvious pulsation within the abdomen.
Significance
- Suggestive of abdominal aortic aneurysm, though the normal pulsation of the abdominal aorta may be visible in thin people.
Visible Peristalsis
Look For
- Waves of movement across the abdomen, often starting in the left upper quadrant and moving toward the right lower quadrant.
Significance
- Mechanical intestinal obstruction.
Causes of Visible Peristalsis
- Hernia
- Diverticular disease
- Tumour - colorectal, lymphoma
- Adhesions - congenital, surgery, inflammation
- Strictures - Crohn's, surgery, radiotherapy
- Foreign body - swallowed material, bezoar, parasite
- Intussusception
- Volvulus
Non-mechanical causes of obstruction such as paralytic ileus and Ogilvie's syndrome will not result in visible peristalsis as gut motility is reduced.
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------