this type of fluid produced buldging flanks  that are dull to percussion. The umbilicus may protrude. 

turn the patient onto one side to detect the shift in position of the fluid level.  (shifting dullness).

this is a common cause of a pelvic mass.

listen for the fetal heart.

this is usually dull to percussion. air filled bowel is displaced to the periphery. 

causes include ovarian tumors and uterine myomata. 

Occasionally a markedly distended bladder may be mistaken for such a tumor. 

this type of distention may be localized or generalized. It causes tympanic percussion note. 

more serious are intestinal obstruction and adynamic paralytic ileus. 

Distention becomes more marked in colonic than in small bowel obstruction. 

this is the most common cause of a protuberant abdomen. 

it thickens the abdominal wall, the mesentery, and omentum. 

the umbilicus may appear sunken. 

A pannus, or apron of fatty tissue, may exetend below the inguinal ligaments. Lift to look for inflammation in the skin folds or even for a hidden hernia. 

what type of fatty tumor is a qi stag (not fixed) and non substantial?

lipoma.

subcutaeous tissues found. soft and lobulated. the tumor slips from under your finger when you press on it. 

a small midline protrusion through a defect in the linea alba occurs between the xiphoid process and the umbilicus. 

with the patients head and shoulders raised, (or with the patient standing), run your fingerpad down the linea alba to feel it.

this is a protrusion through an operative scar. 

a small defect, through which a large hernia has passed, has a greater risk for complications than a large defect. 

separation of the two rectus abdominis muscles, through which abdominal contents from a midline ridge when teh patient raises head and shoulders. 

often seen in repeated pregnancies, obesity, and chronic lung disease. It has no clinical consequences.

a protrusion through a defective umbilical ring is most common in infants but also in adults. 

in infants it usually closes within 1-2 years.