09 Local examination of the liver –
are there traces of Hepatophilic Virus in your body?
Liver ache is the subjective symptom of patients suffering from chronic hepatitis, often recurring during fatigue. Examination by percussion may find out the degree of the pain.
Pain at the tapping of the liver zone
Use the right hand fist to tap gently the bilateral hypochondriac region and ask the patient to compare. When tapping the right ribs, the action of the force drives the inflamed liver to move to the center. When the force of action disappears and the liver returns to the original position, the patient would feel dull pain, which is known as pain of the liver zone at tapping. When the pain is acute, it means that the hepatitis is at the active stage.
Whether or not the dull sound boundary between the liver zone and the spleen zone is normal
Big liver and spleen are the reliable traces of the infestation of hepatophilic virus. It is, therefore, an important means to give precise diagnosis and treatment by ascertaining whether the liver is inflamed. The so-called “percussion” is to examine the dull sound boundary of the lower fringe of the liver zone.
Method of percussion
It is very simple:
1.Put the middle figure of the left hand flat on the belly ;
2.Put the left hand by the navel and use the middle finger of the right hand bent vertically and slowly move toward the ribs;
3. Make use of the movement of the waist joint and tap using the middle finger tip of the right hand to tap the second joint of the middle finger of the left hand;
Due to differences of the media of the intestine chamber, the sounds are different. When the intestine has too much air inside, it produces a empty sound. But with liver inside which is a solid organ, the sound remains dull. The position of the lower fringe of the dull sound of the liver thus can be judged.
The normal lower boundary of the liver should be 1.5cm above the rib fringe (that is, the tap on the first joint of the left finger lying flat on the rib fringe, the sound should be an empty sound; while tapping at the second finger above the rib fringe, it should produce the dull sound). If the sound boundary is abnormal, the diagnosis can be made by consulting the clinical data.
Method of self-examination
Put the left hand flat on the skin on the upper right side of the belly.Then use the middle finger of the right hand, bent vertically, and use the tip of the finger to tap, at intervals, the second joint of the middle finger of the left hand, in order to produce the sound.
While tapping, then move both hands up toward the right ribs until a dull sound is produced, thus finding the lower boundary of the liver size.
When the middle left finger is placed at the rib fringe, the tapping sound is dull, the liver is normal.(Figure: demonstrative figure of the tapping of the dull sound boundary of the liver.)
The middle finger is the first horizontal finger below the ribs.
The index finger is the first horizontal finger on the ribs.
