Liver span : Wikipedia, the free encyclopedia

Liver span

Liver span
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] Depending on the physician's technique, estimates of the same liver span can vary by 8 cm (3.1 in), on average.^[5]

References

^ 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.
^ "Evidence Base - Liver & Ascites Exam - Physical Diagnosis Skills - University of Washington School of Medicine". Retrieved 2009-04-05.
^ "Examination of the Liver".
^ "Evaluation of the Size, Shape, and Consistency of the Liver". Clinical Methods: The History, Physical, and Laboratory Examinations. Butterworths. 1990. ISBN 9780409900774.
^ McGee, Steven. Evidence-Based Physical Diagnosis. p. 434. ISBN 978-0-323392761.

Medical examination and history taking

Medical history

Chief complaint
History of the present illness
Systems review
Nursing assessment
Allergies
- Medications
Past medical history
Family history
Social history
Psychiatric history
Progress notes
Mnemonics
- SAMPLE
- OPQRST
- SOAP
- COASTMAP

Physical examination

General/IPPA	Inspection Auscultation Palpation Percussion
Vital signs	Temperature Heart rate Blood pressure Respiratory rate
HEENT	Eye examination Ophthalmoscopy Swinging light test Hearing Weber Rinne
Respiratory	Respiratory sounds
Cardiovascular	Cardiac examination Peripheral vascular examination Heart sounds Other Abdominojugular test Ankle–brachial pressure index
Abdominal	Liver span Rectal examination Bowel sounds
Musculoskeletal	Knee examination Hip examination Shoulder examination Elbow examination GALS screen
Neurological	Mental status Mini–mental state examination Cranial nerve examination Upper limb neurological examination
Neonatal	Apgar score Ballard Maturational Assessment
Gynecological	Well-woman examination Pap test Breast examination
Sports	Athletic heart syndrome Sudden cardiac death RED-S