84298 - Semeiotics of the Abdomen

Learning outcomes

Describe the basic elements of the physical examination and instrumental evaluation, and recognize normal results.

Course contents

The course provides the theoretical foundations of abdominal semiotics, introducing students to the principles of history taking, physical examination, and interpretation of the main abdominal and urinary signs and symptoms. Particular emphasis is placed on the semiotic significance of clinical findings and on the structured collection and organization of clinical information as the basis for subsequent diagnostic reasoning. Clinical examples are used throughout the course to illustrate the interpretation of symptoms and physical signs in common abdominal disorders.

The course includes the following topics:

1. Introduction to clinical semiotics

• Principles and objectives of clinical semiotics.
• Distinction between signs and symptoms and their role in clinical assessment.
• The semiotic method and structured collection of clinical information.
• Introduction to the hypothetico-deductive approach as the conceptual framework linking semiotics to subsequent clinical reasoning.

2. Medical history taking

• Structure and components of a complete medical history, including chief complaint, history of present illness, past medical and surgical history, medication history, allergies, family history, social history, and review of systems.
• Principles of patient interviewing, including patient-centered communication, open- and closed-ended questioning, active listening, clarification, summarization, and management of sensitive topics.
• Collection and organization of clinically relevant information.

3. Physical examination of the abdomen

• General observation of the patient and assessment of overall clinical condition.
• Inspection of the abdomen, including abdominal contour, surgical scars, abdominal wall abnormalities, and superficial venous circulation.
• Auscultation of bowel sounds and vascular bruits.
• Percussion of the abdomen, including assessment of tympany, organ dullness, and costovertebral angle tenderness.
• Superficial and deep palpation, with recognition and interpretation of abdominal tenderness, guarding, rigidity, organ enlargement, and the principal abdominal semiotic landmarks.

4. Semiotics of abdominal and urinary symptoms

• Semiotic approach to abdominal pain, including pain characteristics, localization, radiation, and patterns of visceral and somatic pain.
• Semiotics of upper gastrointestinal symptoms, including dyspepsia, nausea, vomiting, and dysphagia.
• Semiotics of gastrointestinal bleeding, including hematemesis, melena, hematochezia, and enterorrhagia.
• Semiotics of changes in bowel habits, including diarrhea and constipation.
• Semiotics of acute abdominal conditions, including ileus, bowel obstruction, bowel perforation, and their associated clinical and physical findings.
• Semiotics of jaundice, including its clinical presentation, pathophysiological classification, and associated signs and symptoms.
• Semiotics of urinary symptoms, including alterations in urine volume and appearance, disorders of micturition, urinary retention, urinary incontinence, and the clinical distinction between urinary retention and anuria.

Readings/Bibliography

Bates' Guide to Physical Examination and History Taking 12th Edition (available either as printed copy or as ebook format)

Teaching methods

Lessons

Assessment methods

The exam for Semiotics of the Abdomen consists of an oral examination aimed at assessing the student’s ability to understand and apply the key concepts of clinical semiotics related to abdominal signs and symptoms.

The final mark for this module will be expressed in thirtieths (up to 30 cum laude). This grade contributes to the overall grade of the integrated course, which also includes assessments in the following modules:

• Biochemistry

• Anatomy

• Physiology

• Semiotics of the Abdomen

The final grade for the integrated course is calculated as a weighted average of the individual module grades, according to the respective ECTS credits.

Evaluation criteria for the Semiotics module:

During the oral exam, students will be assessed based on:

• Knowledge and understanding of abdominal signs and symptoms, their physiopathological basis, and their clinical relevance

• Ability to organize and communicate clinical information in a clear, structured, and concise manner

• Correct use of medical terminology, particularly when describing signs, symptoms, and physical examination findings

• Ability to apply the semiotic method, including the recognition, classification, and interpretation of symptoms and signs related to abdominal conditions

• Basic clinical reasoning, understood as the ability to logically connect the collected data (from history and examination) to describe plausible clinical scenarios — without requiring formal diagnostic formulations

Teaching tools

PPT slides

Office hours

See the website of Francesco Tovoli