Liver span

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Liver span
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Anterior view of the position of the liver (red) in the human abdomen.

The liver span is a measurement performed during physical examination to determine the size of the liver and identify possible hepatomegaly.

It is the distance between the lower border of the liver in the mid-clavicular line obtained by palpation, and the upper border of the liver in the mid-clavicular line detected by percussion (the upper border of the liver lies behind the ribs and can not be palpated). More accurate methods of estimating liver span include ultrasound and cross-sectional imaging (computed tomography or magnetic resonance imaging). [1]

Normal liver span is 6–12 cm (2.4–4.7 in), but varies with age, height, and weight. [2] [3] [4] Furthermore, depending on the physician's technique, estimates of the same liver span can vary by 8 cm (3.1 in), on average. [5]

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Medical ultrasound Diagnostic imaging technique

Medical ultrasound is a diagnostic imaging technique, or therapeutic application of ultrasound. It is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs. Its aim is often to find a source of a disease or to exclude pathology. The practice of examining pregnant women using ultrasound is called obstetric ultrasound, and was an early development and application of clinical ultrasonography.

Clavicle Long bone that serves as a strut between the scapula and the sternum

The clavicle, or collarbone, is a slender, S-shaped bone approximately 6 inches (15 cm) long bone that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the right. The clavicle is the only long bone in the body that lies horizontally. Together with the shoulder blade, it makes up the shoulder girdle. It is a touchable bone, and in people who have less fat in this region, the location of the bone is clearly visible, as it creates a bulge in the skin. It receives its name from the Latin clavicula, because the bone rotates along its axis like a key when the shoulder is abducted. The clavicle is the most commonly fractured bone. It can easily be fractured due to impacts to the shoulder from the force of falling on outstretched arms or by a direct hit.

Cytopathology A branch of pathology that studies and diagnoses diseases on the cellular level

Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. The discipline was founded by George Nicolas Papanicolaou in 1928. Cytopathology is generally used on samples of free cells or tissue fragments, in contrast to histopathology, which studies whole tissues. Cytopathology is frequently, less precisely, called "cytology", which means "the study of cells".

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Elastography

Elastography is a medical imaging modality that maps the elastic properties and stiffness of soft tissue. The main idea is that whether the tissue is hard or soft will give diagnostic information about the presence or status of disease. For example, cancerous tumours will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones.

Sternocleidomastoid muscle

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Splenomegaly Medical condition

Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of hypersplenism which include: some reduction in number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any combination; a compensatory proliferative response in the bone marrow; and the potential for correction of these abnormalities by splenectomy. Splenomegaly is usually associated with increased workload, which suggests that it is a response to hyperfunction. It is therefore not surprising that splenomegaly is associated with any disease process that involves abnormal red blood cells being destroyed in the spleen. Other common causes include congestion due to portal hypertension and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen, along with caput medusae, is an important sign of portal hypertension.

Palpation

Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine its size, shape, firmness, or location.

Hepatomegaly Medical condition

Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.

Abdominal examination Physical examination of abdomen

An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The physical examination typically occurs after a thorough medical history is taken, that is, after the physician asks the patient the course of their symptoms. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity, or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the respiratory examination and cardiovascular examination.

In medicine, Murphy's sign is a maneuver during a physical examination as part of the abdominal examination. It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.

In medicine, the cardiac examination, also precordial exam, is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination.

Castells sign Medical sign assessed to evaluate splenomegaly

Castell's sign is a medical sign assessed to evaluate splenomegaly and typically part of an abdominal examination. It is an alternative physical examination maneuver to percussion over Traube's space.

Focused assessment with sonography in trauma is a rapid bedside ultrasound examination performed by surgeons, emergency physicians, and paramedics as a screening test for blood around the heart or abdominal organs (hemoperitoneum) after trauma.

Abdominal ultrasonography

Abdominal ultrasonography is a form of medical ultrasonography to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall. For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs.

The liver scratch test is a technique used by medical professionals during a physical exam to locate the inferior border of the liver in order to approximate the size of a patient's liver. The technique was first credited to Burton-Opitz in 1925 where it was used to identify the cardiac silhouette, however there are references of similar techniques used prior to this. The liver scratch test can be used when other exam techniques used to approximate liver size are ineffective and is thought to be most useful if the abdomen is distended, too tender for direct palpation, the abdominal muscles are too rigid, or the patient is obese.

Scrotal ultrasound Medical ultrasound examination of the scrotum.

Scrotalultrasound is a medical ultrasound examination of the scrotum. It is used in the evaluation of testicular pain, and can help identify solid masses.

Renal ultrasonography

Renal ultrasonography is the examination of one or both kidneys using medical ultrasound.

Ultrasonography of liver tumors involves two stages: detection and characterization.

References

  1. Gosink, BB; Leymaster, CE (January 1981). "Ultrasonic determination of hepatomegaly". Journal of Clinical Ultrasound. 9 (1): 37–44. doi:10.1002/jcu.1870090110. PMID   6792230.
  2. "Evidence Base - Liver & Ascites Exam - Physical Diagnosis Skills - University of Washington School of Medicine" . Retrieved 2009-04-05.CS1 maint: discouraged parameter (link)
  3. "Examination of the Liver".
  4. "Evaluation of the Size, Shape, and Consistency of the Liver". Clinical Methods: The History, Physical, and Laboratory Examinations. Butterworths. 1990. ISBN   9780409900774.
  5. McGee, Steven. Evidence-Based Physical Diagnosis. p. 434. ISBN   978-0-323392761.