As with examination of the thorax, abdominal examination can be considered under inspection, palpation, percussion and auscultation: inspection and palpation usually providing the most information. In this text, percussion is considered before palpation, since it provides useful preliminary information on tenderness and the position of organs, thus modifying the depth of palpation and showing where to palpate for the liver and spleen.
The environment must be warm and the patient relaxed, having emptied their bladder. They should lie supine with one pillow supporting the head, unless this produces dyspnea or discomfort. Hands are placed by the sides, and the legs are extended and uncrossed. The abdomen should be fully exposed. In the male this is up to the nipples, the breasts being covered in the female. The examination must include the genitalia, but these areas are kept covered under a sheet until this part of the examination is reached, in order not to embarrass the patient.