What is the standard sequence of a focused abdominal examination?

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

Answer: (A)

In a focused abdominal exam, the order is chosen to prevent altering what you’re trying to observe. Start with inspection to visually assess the abdomen for contour, distension, scars, masses, or signs of trauma. Then listen with auscultation before touching the abdomen, because hearing bowel sounds and vascular noises should reflect the natural state without interference from palpation or percussion. Next, use percussion to gauge density and detect fluid, gas, or enlarged organs; doing this after auscultation avoids misinterpreting sounds that could be influenced by prior tapping. Finally, perform palpation to assess tenderness, guarding, or masses, since touching the abdomen can provoke responses that change both the appearance and the sounds you’ve just listened to. This sequence—inspection, auscultation, percussion, palpation—minimizes interference with findings and provides the most reliable assessment.