Liver and gallbladder percussion

Liver and gallbladder percussion is an auxiliary method used to check whether the abdomen is normal. The purpose is to diagnose the upper and lower hepatic and hepatic areas of the liver and the gallbladder for sputum pain. Hepatic sputum pain has a certain significance for the diagnosis of hepatitis and liver abscess; the position of the gallbladder is deep, and the size can not be found by the method of percussion, but the gallbladder licking pain can help the diagnosis of cholecystitis. Through this examination, the lesion and the corresponding symptoms can be judged. In the hepatic area, the spleen is diagnosed in the spleen. When the spleen is not satisfied with palpation or there is little spleen in the rib, the spleen should be used to further examine the size of the spleen. Basic Information Specialist classification: Digestive examination classification: other examinations Applicable gender: whether men and women apply fasting: not fasting Tips: The examinee takes the left lateral position. Normal value Normal liver, upper and lower liver is suitable for clinical physiology and liver area, gallbladder without sputum pain. Clinical significance Abnormal result 1, liver area sputum pain has a certain significance for the diagnosis of hepatitis, liver abscess; gallbladder position is deep, can not be used to find out its size by percussion, but gallbladder sputum pain, help the diagnosis of cholecystitis. 2, abnormalities in the liver area and gallbladder percussion are spleen voiced area changes, spleen voiced area expansion seen in various causes of splenomegaly. Spleen dull sound area is seen in the left pneumothorax, gastric dilatation, tympanic and so on. 3, under pathological conditions, the liver dullness is seen in the right pulmonary fibrosis, right lower lung atelectasis, pneumoperitoneum and tympanic bowel; liver dullness is seen in emphysema, right tension pneumothorax, visceral drooping. The dullness of the liver is seen in liver cancer, liver abscess, hepatitis, hepatic congestion, polycystic liver disease, etc.; under the armpit abscess, due to the liver down and the diaphragm, the liver dull area is also enlarged, but the liver itself does not increase. The dullness of the liver is found in acute hepatic necrosis, cirrhosis and flatulence. The disappearance of the dullness of the liver is replaced by the drum sound, which is caused by the covering of the liver surface. It is an important sign of acute gastrointestinal perforation. People who need to be examined: routine physical examination items, abnormal abdominals. Precautions Requirements for examination: 1 The sniper strength should be appropriate at the time of percussion, should not be too light or too heavy; 2 when the right sacral midline and right scapula line are diagnosed, the left side can be taken by the examinee; 3 due to the lower hepatic border and stomach, colon If the organs overlap, it is difficult to accurately locate the percussion, so palpation or hearing can be used. Inspection process When the legal upper hepatic boundary is used for percussion, it is generally along the midline of the right clavicle, the midline of the right iliac crest, and the right scapula line. Use your fingers to be appropriate, not too light or too heavy. When it is changed from unvoiced to voiced, it is the upper limit of the liver. This is equivalent to the top of the liver covered by the lungs, so it is also called the liver relative to the voiced boundary. Then squat down between 1 and 2 intercostals, the voiced sound becomes a real sound, and the liver here is no longer covered by the lungs and directly close to the chest wall, which is called the absolute dullness of the liver, and is also the lower lung boundary. When determining the lower hepatic boundary, it is better to squat up from the midline of the right clavicle or the midline of the abdominal drum sound zone. It is easier to distinguish the drum sound from the human ear. At this time, if the percussion sound is changed from the drum sound to the voiced sound. However, because the lower hepatic border overlaps with the stomach and colon, it is difficult to determine the standard, so it is often determined by palpation or auscultation. Generally, the lower hepatic margin of Chad is 1 to 2 cm higher than the lower edge of the liver, but if the liver margin is significantly thicker, the two results are closer. Pay attention to the body shape when determining the upper and lower boundaries of the liver. The normal liver of the shapely body is on the midline of the right clavicle. The upper boundary is in the fifth intercostal space and the lower boundary is on the lower edge of the right rib. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention. Adverse reactions and risks Nothing.

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