1st - Inspection - Contour (normal, scaphoid, rounded, protuberant), Symmetry (bulging, masses, asymmetric), Umbilicus (midline, inverted, discoloration, bulges, inflammation, hernia), Skin (texture, color, veins, scars, lesions), Striae/tightness, Easy bruising, petechaie
2nd - Auscultation - so not to cause abnormal or hyperactive bowel sounds by palpation first. Begin in RLQ by ileocecal valve, use diaphragm of stethoscope, borborygmus, tinkling (may be sign early obstruction), absent or hypoactive (listen full 5 min. post operative), listen for bruits @ aortic, femoral, iliac, renal arteries.
3rd - Percussion - General tymp = hollow organ/air, bowels (gas) stomach (air), dullness = distended bladder, stool in colon, fluid, mass, ascites, hyperresonance = gaseous distension, Special - differentiate ascites from gaseous dist. - fluid wave, shifting dullness
4th - Palpation - light then med. palpation, judge size, location, consistency of certain organs/mass tenderness