Method Of Exam

• 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.

Normal: 

Liver span in the mid-clavicular line is 6-12 cm.