Percussion

Question 1

How to percuss the liver

Answer 1

percuss up from RIF then down from right side of chest to determine the size of the liver

Question 2

How to percuss the spleen

Answer 2

percuss up from RIF moving towards the left hypochondrium to assess for splenomegaly

Question 3

How to percuss the bladder

Answer 3

percuss suprapubic region

Question 4

how to percuss shifting dullness

Answer 4

1. Percuss from umbilicus to the flank until dullness is noted
2. Keep your finger at this point
3. Ask patient to roll onto the opposite side to which you have detected the dullness
4. Keep the patient on their side for 30 seconds
5. Repeat percussion in the same spot
6. If fluid was present (ascites) then the area that was previously dull should now be resonant
7. If the flank is now resonant, percuss back to the midline, which if ascites is present, will now be dull (i.e. the dullness has shifted)