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. Feel for the liver to hit the caudal aspect of your palpating hand.

What techniques are used in palpation?

Palpation in Physical Exams

• Inspection, the visual examination of the body.
• Palpation, the touching of the body.
• Percussion, the tapping of the body to evaluate the size and consistency of an organ or check for the presence of fluid.
• Auscultation, listening to heart and bowel sounds with a stethoscope.

What does a liver friction rub sound like?

A hepatic friction rub sounds close to the ear and is very similar to the sound produced by forcibly rubbing the thumb and forefinger together close to the ear. If the rub is being produced by movement of the liver, the rub will usually be confined to the abdomen and will not radiate into the chest.

Which technique is correct when palpating the abdomen?

Deep palpation of the abdomen is performed by placing the flat of the hand on the abdominal wall and applying firm, steady pressure. It may be helpful to use two-handed palpation (Figure 93.2), particularly in evaluating a mass. Here the upper hand is used to exert pressure, while the lower hand is used to feel.

Where do you palpate the liver?

Liver: Palpation

• Place your right hand on the patient’s abdomen in the right lower quadrant. Gently move up to the right upper quadrant lateral to the rectus muscle.
• If the liver is enlarged, it will come downward to meet your fingertips and will be recognizable.

How do you palpate?

Palpation requires you to touch the patient with different parts of your hands, using varying degrees of pressure. Because your hands are your tools, keep your fingernails short and your hands warm. Wear gloves when palpating mucous membranes or areas in contact with body fluids. Palpate tender areas last.

Can you feel pleural friction rub?

There’s a small fluid-filled space between them known as the pleural cavity. You may experience pain and a pleural friction rub when these two layers of tissue become inflamed or if they lose the lubrication between them.

What does a pleural effusion sound like?

The sound has been described as “grating,” “creaky,” or similar to “the sound made by walking on fresh snow.” Pleural rubs can be caused by several different etiologies, which include any condition that results in pleural effusion, pleurisy, or serositis.

Which location does a nurse select when palpating a patient’s liver?

To palpate the liver, place your left hand under your patient, parallel to and supporting the right 11th and 12th ribs and your right hand lateral to the rectus muscle with your fingertips below the liver border (as identified by dullness during percussion).

When is deep palpation used?

While the superficial palpation provides information about potential areas of tenderness, superficial structures, and the abdominal wall, deep palpation permits inspection of the internal organs and delineation of the intra-abdominal masses. Additional areas of tenderness could be identified by deep palpation as well.

How do you palpate the liver with your left hand?

Liver Palpation. To perform palpation of the liver, place your left hand posteriorly between the patient’s right 12th rib and the iliac crest, lateral to the paraspinal muscles. Place your right hand in the patient’s right upper quadrant parallel and lateral to the rectus muscles and below the area of liver dullness.

How do you perform a bimanual liver palpation?

For bimanual liver palpation, place the left hand posteriorly at the level of the two lower ribs and gently press upward to elevate the liver into a more accessible position. Ask the patient to take a deep breath and perform palpation with the right hand as demonstrated previously.

What is the proper position for palpation during a liver exam?

Palpation During the Liver Exam. With patient supine, place right hand on patient’s abdomen, just lateral to the rectus abdominis, well below lower border of liver dullness.

How do you hook the liver for a CT scan?

The examiner stands near the patient’s head and places both hands together below the right costal margin and the area of dullness. The examiner presses inward and upward and ”hooks” around the liver edge while the patient inhales deeply. The technique of hooking the liver is shown in Figure 17-24.