Clinical maneuver shown in Photograph is used for ?
A. Palpation of Left kidney.
B. Presence of ascites.
C. Palpation of Spleen.
D. Palpation of Liver.
Ans:D. Palpation of Liver
Assessing Abdominal Structures by Palpation
Abdominal Aorta
To palpate the abdominal aorta, place your fingers in the epigastric portion of the abdomen and slightly toward the patient’s left midclavicular line.Palpate for aortic pulsations. You can also assess the width of the aorta by placing one hand on each side of the aorta.
Liver
To palpate the liver,place your right hand at the patient’s right midclavicular line under the costal margin. Place your left hand posteriorly on the patient’s right eleventh to twelfth rib and press upward to elevate the liver toward the abdominal wall. Have the patient inhale and exhale deeply while you press your right hand gently but deeply in and up during inspiration. The hooking technique is another way to palpate the liver.Place your hands over the right costal margin and hook your fingers over the edge. Have the patient take a deep breath and feel for the liver’s edge as it drops down on inspiration, then rises up over your fingers during expiration.
Spleen
To palpate the spleen, stand on the patient’s right side, place your left hand under the left CVA, and pull upward to move the spleen anteriorly. Place your right hand under the left anterior costal margin and have the patient take a deep breath in and out. During exhalation, press inward along the left costal margin and try to palpate the spleen.
Kidneys
To assess the left kidney, stand on the patient’s right side and place your left hand in the left CVA of her or his back. Place your right hand at the left anterior costal margin. Have the patient take a deep breath, then press your hands together to “capture” the kidney. As the patient exhales, lift your left hand and palpate the kidney with your right hand. To assess the right kidney, remain on the patient’s right side and place your right hand on the right posterior CVA and your left hand on the patient’s right anterior costal margin.When the patient exhales, palpate the kidney.
Bladder
Palpate the bladder in the hypogastric area up to the umbilicus, using deep palpation.
Inguinal Lymph Nodes
Using the pads of your fingers, palpate just below the inguinal ligament for the superficial superior (also called the horizontal) inguinal lymph nodes and along the inner aspect of upper thigh for the superficial inferior (also called the vertical) inguinal lymph nodes.
If nodes are palpable, note size, shape, mobility, consistency, and tenderness