General examination

General examination

The patient must be lying flat with hips and knees extended but without causing distress (this may require provision of a pillow) and the abdomen should be adequately exposed. palpation hips and knees are flexed to ensure relaxation of abdominal muscles. The examination should be performed sequentially , begin ning with general inspection looking for evidence of weight loss, dehydration, pedal oedema, anaemia, jaundice or abnor mal pigmentation. Examination of the hands may provide e dence of anaemia or chronic liver disease whereas examination of the head and neck may identify features indicative of liver disease or cervical lymphadenopathy (particularly left supra clavicular) suggestive of intra-abdominal malignancy . The patient’s vital signs (heart rate, blood pressure, respiratory rate and body temperature) should be noted. In the elective setting the patient’ s weight and body mass index are also recorded.