Percuss the Liver

The upper border of the liver is percussed in the right midclavicular line, starting in the mid-chest. As the chest is percussed downward, the resonant note of the chest becomes dull as the liver is reached. As percussion continues still further, this dull note becomes tympanic because the percussion is now over the colon. The upper and lower borders of the liver should be no more than 4 inches (10 cm) apart. The technique is illustrated in Figure 17-17.

There are several problems with predicting liver size by percussion. If ascites is present, the examiner can only speculate about the correct size of the liver. A more common cause of

overestimating liver size (false-positive measurement) is some form of chronic obstructive lung disease. This makes percussion of the upper border of the liver difficult. Obesity in a patient can cause problems in both percussion and palpation. Distention of the colon may obscure the lower liver dullness. This may result in underestimating the size of the liver (false-negative measurement).

Gaining Weight 101

Gaining Weight 101

Find out why long exhausting workouts may do more harm than good. Most of the body-building workout and diet regimens out there are designed for the guys that gain muscle and fat easily. They focus on eating less and working out more in order to cut the excess fat from their bodies while adding needed muscle tone.

Get My Free Ebook

Post a comment