spleen palpation

The spleen palpation test is an auxiliary examination method for checking whether the abdominal spleen is normal. Under normal circumstances, the spleen cannot be touched. Once touched, the spleen is enlarged to 2-3 times normal. Clinically, both hands are used in palpation. The patient was lying on his back with his legs slightly flexed. The doctor's left hand bypassed the front of the patient's abdomen, and the palm was placed at the 9th to 11th ribs of the left lower chest. The chest was pushed forward and the thoracic movement was restricted with the thumb. The right palm is placed flat on the umbilicus, and the palpation starts from the umbilical plane. It is roughly perpendicular to the left rib arch. It is like palpation of the liver. With breathing, it gradually goes up and touches the tip of the spleen until the left rib. When the spleen is slightly enlarged and the supine position is not easy to reach, the patient may be taken in the right lateral position, the lower extremities are flexed, and the palpation is easy to reach with both hands. Basic Information Specialist Category: Inspection Category: Physical Examination Applicable gender: whether men and women apply fasting: not fasting Tips: Actively cooperate with the doctor's work. Normal value Under normal circumstances, the spleen cannot be touched. The spleen is a substantial organ rich in blood supply, soft and brittle. It is generally considered that the physiological spleen is 10 to 12 cm long, 6 to 8 cm wide, 3 to 4 cm thick, and weighs 110 to 200 g. The spleen is located deep in the left rib of the left rib area, opposite to the 9-11 rib, and the long axis is consistent with the 10th rib. The sacral surface is adjacent to the diaphragm and the left rib sinus. The stomach is in front, the posterior is adjacent to the left kidney and the left adrenal gland, and the lower end is adjacent to the spleen sulcus. The spleen is adjacent to the tail of the pancreas. The spleen is an intraperitoneal organ that is connected to adjacent organs by the gastric spleen ligament, spleen and kidney ligament, spleen ligament and spleen colon ligament. Clinical significance Abnormal results: In the clinical classification of splenomegaly, the splenomegaly is generally divided into light, medium and high. When inhaling deeply, the spleen edge is not more than 2cm below the rib, which is mildly enlarged; above 2cm to the umbilical horizontal line, it is moderately enlarged; above the umbilical horizontal line or the anterior median line is highly enlarged, also known as giant spleen. Regular physical examination items for people who need to be examined, abnormal abdominals. The result is low, may be disease: the result of high spleen spleen may be disease: chronic congestive splenomegaly in children, precautions for hypersplenism Requirements for examination: The measurement method for splenomegaly is usually expressed by three lines: the "1" line (also known as the line A) refers to the distance (in centimeters) from the left rib of the left clavicle to the lower edge of the spleen. When the spleen is slightly enlarged, only the first measurement is made. When the "2" line and the "3" line spleen are obviously enlarged, the "2" line (甲甲线线) and the "3" line (丁丁线) should be added. The former refers to the intersection of the left clavicle midline and the left costal edge. The distance from the farthest point of the spleen (should be greater than the "1" line), the latter refers to the distance between the right edge of the spleen and the front midline. If the spleen height increases to the right over the midline, the maximum distance from the right edge of the spleen to the median line is measured, indicated by “+”; the shortest distance between the right edge of the spleen and the median line is measured without exceeding the median line, indicated by “one” . Inspection process 1. Shallow palpation method: When the spleen is swollen and shallow, the patient's right hand can be used to palpate the spleen with light force. 2, double palpation method: when the spleen swelling is deep, use the two-hand palpation method for examination. The paralyzed patient knees in the supine position or the right lateral position. The examiner's left hand is placed forward at the 7th to 10th ribs behind the spleen, and the thorax is fixed as much as possible. The paralyzed patient performs a deep abdominal breathing exercise. The examiner's right hand is placed flat on the abdomen. The long axis of the hand is perpendicular to the left rib arch, and then gradually approaches the left rib arch from bottom to top. The tip of the finger is slightly curved and gently pressed into the abdominal wall. When the patient inhales deeply, the spleen descends and hits the palpated finger, and the lower edge of the spleen can be touched. When the patient is slightly swollen and the supine position is not easy to reach, the patient may be transferred to the right lateral position. The patient's right lower limb is straightened, and the left lower limb is bent and the knee is examined. It is easier to touch the slightly enlarged spleen. 3, impact palpation: for patients with ascites palpation of the spleen. 4, counter-attack palpation method This method to check the spleen mobility to determine whether the spleen has adhesions. The method is similar to the palpation method of the hands. One hand presses the surface of the spleen on the anterior abdominal wall and is fixed. The other hand is in the gap below the ribs on the outer side of the sacral spine, and the impact in the direction of the front abdominal wall can be repeated several times. For example, the hand on the front abdominal wall has a sense of impact, indicating that there is no adhesion around the spleen. Palpation content: including the size of the spleen, surface condition, texture, edge, presence or absence of tenderness and friction. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention.

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