What is the standard sequence for a comprehensive abdominal examination?

• A. Inspection, auscultation, palpation, percussion
• B. Inspection, auscultation, percussion, palpation
• C. Auscultation, inspection, percussion, palpation
• D. Inspection, percussion, auscultation, palpation

Answer: (B)

The main idea is to follow an order that preserves the natural findings as you evaluate the abdomen. Start with inspection to note contour, symmetry, skin changes, and any visible abnormalities. Then listen with a stethoscope to assess bowel sounds and vascular sounds; this must come before any touching because manipulating the abdomen can alter motility and sound production. Next, use percussion to evaluate what lies beneath—air, fluid, or solid tissue—and to estimate liver size and detect abnormal densities. Doing this after auscultation keeps the auditory findings reliable. Finally, palpate to assess tenderness, guarding, masses, and organ size; palpation is kept last because it can provoke pain, reflexes, or further alter bowel sounds, which could confound earlier observations. This sequence helps you gather accurate, baseline information without disturbing the findings.