Percussion tells you what is under your fingers before you press; palpation goes light before deep, and the painful quadrant goes last. Interpret a percussion note by site, measure a real liver span, decide when deep palpation is forbidden, name the focused maneuvers, and separate expected lifespan variation from findings that need a phone call.
What did that note mean?
Percuss lightly in all four quadrants in the same clockwise pattern you auscultated. Choose where you percussed and what you heard.
The dominant note over a normal abdomen is tympany — gas in the stomach and intestines. Scattered dullness is expected over the liver, a full bladder, a full colon and the spleen. Anything else means gas has been replaced by fluid, stool, a mass or a gravid uterus.
Measure the liver span
Start well below the umbilicus over tympany and percuss upward until the note turns dull — that is the lower border. Then start over lung resonance around the fourth intercostal space and percuss downward until dullness begins — the upper border. Mark both with a skin pencil and measure between them.
Expected adult span: 6 to 12 cm at the midclavicular line, 4 to 8 cm at the midsternal line.
How deep do you go?
Light palpation depresses 1 to 2 cm; deep palpation depresses 4 to 6 cm (some texts teach 5 to 8). Read the patient and choose.
At the bedside
0
Correct
0
Answered
10
Total
Name the maneuver
Read what was done and what happened, then name it. Feedback gives you the technique, the positive finding and what you do about it.
At the bedside
0
Correct
0
Answered
8
Total
Expected for this patient, or not?
Infants, children, pregnancy and older adults change what “normal” means — and in older adults they change how loudly an emergency announces itself.