Lying supine
If you wish to palpate on the skin, provide a private room. Ask the patient if he/she is willing to uncover the abdominal area ñ removing the shirt for men and for women, either wearing a halter top or two piece bathing suit, etc. or rolling the shirt up to uncover the abdominal area. While the skin can not be viewed with clothes covering the area, the external oblique abdominis muscle may be palpable over clothing.
Anterior to the patient.
(Guide the patient to drape appropriately.) Please lie on your back. May I touch your abdomen? (or point to the area). Please reach with your hand toward your opposite knee. (If needed, hold in this position while I try to push you back.)
Guide the patient to drape appropriately. Guide the patient to lie supine. With the patient relaxed and with
permission, place your fingers on the right (left) external oblique abdominis muscle. Guide the patient to
flex the trunk to about 45° while reaching toward the left (right) knee. With unclear muscle activity, increase the contraction of the external oblique abdominis by asking the patient to:
ï flex the trunk to about 45∞and put his/her hands on the opposite shoulders and lead with the right (left) elbow
ï flex the trunk to about 45∞and put his/her hands behind the head and lead with the right (left) elbow
ï flex the trunk to about 45∞and put his/her hands on the opposite shoulders and lead with the right (left) elbow
ï flex the trunk to about 45∞and put his/her hands behind the head and lead with the right (left) elbow
VH - Spine skeleton with external oblique abdominis
On the other side add rectus sheath, rectus and internal oblique abdominis muscles, transverses abdominis, inguinal ligament, intercostals, pectoralis major muscles and tendons