- Organs and masses
- Liver span
- Ascites: Fluid thrill (large amount) Shifting dullness
examines fluid or gas contents of the mass - dull (fluid, tissue) or resonance (Gas, Cyst)
Done to lipoma’s
Step of measuring organ size
- Percuss the nine regions
- Check for any mass… etc..
- Shifting, costrophrenic angle percussion for pyelonephritis
- start from right to left region to check any megaly/mass
- start midclavical line - 2nd intercostal space
- place fingers flat - measure by both sides by placing marked dullness from illiac fossa and below the clavicles - size 8-12 male // 8-10 females
- for spleen, same steps as above but on opposite side
- check for ascites and costrophrenic angle
Costophrenic angle for pyelonephritis place palm on back, and use fist to percuss
- dulness and ressonance is not important in this part of examination
- Mostly to check if there is any mass
fluid Assessment of abdominal
Ascites - Fluid thrill test Severe ascites, will resulted in …
- main indicator by simple touch, with slight movement of abdominal region
- Put hand on other side, and stimulate the abdomen from opposite side - (((whilst asking patient put their hand in midline))); to prevent transmission of fluid through anterior abdominal wall
shifting dullness Mild to moderate ascites are usually on flanks - You can check by percussion -
- dullness progressively getting more by flanks -
- to assure its ascites or mass; keep hand same position by 20-30 seconds;
- do the percussion again after switching patient to other side; if mass it will be dull - if ascites the fluid directed downwards resulting in shifting dullness & resonance -