Method Of Exam
|Author: A. Chandrasekhar, MD
||Consultant: J. Pickleman, MD
and M. Klamut, MD
- Starting at a level below the umbilicus in the right mid-clavicular line, lightly percuss upward toward the liver. Ascertain the lower border of liver dullness.
- Identify the upper border of liver dullness in the mid-clavicular line by lightly percussing from lung resonance down toward liver.
An alternate method of estimating liver size is the scratch test.
- Keep the diaphragm of your stethoscope over the liver dullness.
- Start scratching the abdominal wall starting from the right lower quadrant parallel to the liver edge.
- There will be a sudden transition of increased transmission of sound once the liver edge is reached.
- Similar maneuvers will determine the upper edge.