How do you document percussion of the liver?
How do you document percussion of the liver?
The purpose of liver percussion is to measure the liver size. Starting in the midclavicular line at about the 3rd intercostal space, lightly percuss and move down. Percuss inferiorly until dullness denotes the liver’s upper border (usually at 5th intercostal space in MCL). See 5-7-9 rule.
How do you document liver palpation?
Begin palpation over the right lower quadrant, near the anterior iliac spine. Palpate for the liver with one or two hands palm down moving upward 2-3 cm at a time towards the lower costal margin. Have the patient take a deep breath. The liver will move downward due to the downward movement of the diaphragm.
How do you document an abdominal exam?
Documentation of a basic, normal abdominal exam should look something along the lines of the following: Abdomen is soft, symmetric, and non-tender without distention. There are no visible lesions or scars. The aorta is midline without bruit or visible pulsation.
How do I document ascites?
- Assessment for Ascites. Physicians should be familiar with the signs of ascites and physical examination maneuvers that can be used to detect ascites.
- Signs of Ascites. • Increase in abdominal girth and weight gain.
- Fluid Wave Test. • Patient lies supine.
- Shifting Dullness Test. • Patient lies supine.
How do you assess liver span?
More accurate methods of estimating liver span include ultrasound and cross-sectional imaging (computed tomography or magnetic resonance imaging). Normal liver span is 6–12 cm (2.4–4.7 in), but varies with age, height, and weight.
What is normal liver scratch test?
The liver scratch test is a type of auscultatory percussion that uses the difference in sound transmission between solid and hollow organs in the abdominal cavity in order to locate the inferior edge of the liver.
What is the purpose of the liver scratch test?
The scratch test uses auscultation to detect the lower liver edge by using the difference in sound transmission through the abdominal cavity over solid and hollow organs. The test is thought to be particularly useful if the abdomen is tense, distended, obese, or very tender.
How do you document without bowel sounds?
Place the diaphragm of your stethoscope lightly over the right lower quadrant and listen for bowel sounds. If you don’t hear any, continue listening for 5 minutes within that quadrant.
How would you describe ascites in a physical exam?
A DISTENDED ABDOMEN, bulging flanks, and a protruding, displaced umbilicus are signs of ascites, free fluid in the peritoneal cavity. Cirrhosis, heart failure, renal failure, portal hypertension, chronic hepatitis, and cancer are common causes. Shifting dullness and a fluid wave indicate ascites.