Liver palpation method

The method of liver palpation can be divided into one-handed palpation and two-handed palpation, with one-handed palpation being the more common method. The patient is asked to breathe abdominally during palpation, allowing the liver to move up and down, and then the lower edge of the liver is touched by manipulation, which is used to detect whether there is any abnormality in the liver, including the location of the lower edge of the liver, the edge of the liver, texture, surface and pulsatility, etc. 1. One-handed palpation: mainly four fingers of the right hand are combined with the metacarpophalangeal joints straightened and placed parallel to the rib cage, which is used to palpate the lower edge of the liver. The fingers are pressed down when the patient exhales and lifted up when the patient inhales. Move upward in sequence toward the rib margin at a uniform rate and repeatedly perform the examination of the lower edge of the liver for relevant abnormalities; 2. Two-handed palpation method: first hold the patient’s right posterior waist with the left hand, from the lateral side of the paraspinal muscles between the 12th rib and the iliac spine, and open the left thumb over the right rib margin; the left hand can be pushed upward during palpation to limit the expansion of the chest, and the right fingers can easily feel the liver moving downward to improve the effectiveness of palpation. In addition, the lower edge of the liver cannot normally be touched during palpation, while in some people with long and lean bodies, it is possible to touch the lower edge of the liver within 3 centimeters below the glabella, or within 1 centimeter of the lower edge of the right rib cage. In certain cases of abnormal disease, the subhepatic margin may also be palpated under the right costal margin, most commonly with diffuse or limited enlargement of the liver. When liver disease is suspected, liver function tests and ultrasound should be performed in conjunction with palpation by a physician.