an easily palpable impulse suggests this. 

A positive fluid wave, shifting dullness, and peripheral edema make this diagnosis highly likely. 

Risk factors for this are age 65 or older, history of smoking, male gender, and first degree relative with this. 

a periumbilical or upper abdominal mass with expansile pulsations that is 3 cm or more wide suggests this. 

AAA

sensitiving of palpation increases as AAAs enlarge:

for widths of 3-3.9 cm 29%

4-4.9 cm 50%

more than 5 cm 76%

screening by palpation followed by ulttrasound decreases mortality, espeically in male smokers 65 years and older. Pain may signal rupture. 

Rupture is 15 times more likely in AAA more than 4 cm than in smaller anneyrysms.

Suspect this if a mass is found on the left flank. 

if a notch is palpated on medial border, the edge extends beyond midline, percussion is dull, and your fingers can probe deep to the medial border but NOT between the mass and the costal margin. 

confirm findings with other evaluations. 

suspect this if preservation of normal tymphany in the LUQ and the ability to probe with your fingers between the mass and the costal margin, but NOT

deep to its medial and lower borders. 

this is eight times more likeley to happen when the spleen is palpable. 

causes include portal hypertension, hematologic malignancies, HIV infection, and splenic infarct or hematoma.

it is palpable just deep to the left costal margin. 

this is a positive sign when a change in percussion note from tymphany to dullness on inspiration suggests splenic enlargement. 

fluid or solids in the stomach or colon may also cause dullness in the Traube's space. 

if percussion dullness is present, palpation correctly detects presence or absence of splenomegaly or than 80 % of the time. 

rebound tenderness suggests this type of inflammation. 

if tenderness is felt elsewhere than where you were tying to elicit rebound, that area may be the real source of the problem. 

abdominal pain with coughing or light percussion suggests this type of inflammation. 

air bubble on the right

liver dullness on the left

this will appear when there is as little 100 ml of upper gastrointestinal bleeding, 

hematochezia if more than 1000 ml of blood, usually from lower gastrointestinal bleeding. 

oily residue, sometimes frothy or floating, occurs with steatorrhea, or fatty diarhea stools, from malabsorption with celiac sprue, 

pancreatic insufficiency, and small bowel obstruction. 

visceral periumbilical pain may signify eary actue appendicitis from distention of an inflamed appendix.

it gradually changes to partietal pain in the RLQ from inflammation of the adjacent pariteal peritoneum.

doubling over with cramping coliky pain indicates

GERD

complain of heartburn, acid reflux, or regurgitation. if patients report these symptoms more than once a week this is GERD> until proven otherwise.