PHYSICAL EXAMINATION OF THE SPLEEN

EXAMINATION OF THE SPLEEN PERCUSSION PALPATION INSPECTION? AUSCULTATION? COMPLIMENTARY

THE SPLEEN 10TH RIB SPLEEN

EXAMINATION OF THE SPLEEN PERCUSSION OF TRAUBE’S SPACE – SIXTH RIB SUPERIORLY, MIDAXILLARY LINE LATERALLY AND LEFT COSTAL MARGIN INFERIORLY. NORMALLY THE PERCUSSION NOTE IS RESONANT. DULLNESS IMPLIES SPLENOMEGALY. CASTELL’S METHOD – PERCUSS IN THE LOWEST INTERCOSTAL SPACE IN THE LEFT MIDAXILLARY LINE IN BOTH EXPIRATION AND FULL INSPIRATION. NORMALLY THE PERCUSSION NOTE IS RESONANT. DULLNESS IMPLIES SPLENOMEGALY. NIXON’S METHOD NIXON’S METHOD – PERCUSS MIDWAY ALONG LEFT COSTAL MARGIN. NORMALLY DULLNESS DOES NOT EXTEND FURTHER THAN 8 CM ABOVE THE COSTAL MARGIN.

EXAMINATION OF THE SPLEEN - PALPATION BIMANUAL PALPATION SUPINE DEEP BREATH BALLOTTEMENT PALPATION FROM ABOVE - HOOKING FLEX KNEES AND HIPS RIGHT LATERAL DECUBITUS POSITION

ARE ENLARGED SPLEENS EVER NORMAL? 3% OF HEALTHY COLLEGE STUDENTS 12% OF NORMAL WOMEN POSTPARTUM 2.3 – 3.8% OF PATIENTS IN AN OFFICE PRACTICE

COMMON ETIOLOGIES OF SPLENOMEGALY PORTAL HYPERTENSION HEMATOLOGIC MALIGNANCY LYMPHOMA,LEUKEMIA INFECTIOUS DISEASE HIV,MONONUCLEOSIS,MALARIA SPLENIC HEMATOMA

KEHR’S SIGN REFERRED PAIN TO THE LEFT SHOULDER AS A CONSEQUENCE OF AN IRRITATED LEFT HEMIDIAPHRAGM. MAY BE DUE TO SPLENIC RUPTURE.

SUMMARY PERCUSS FIRST AND IF POSITIVE THEN PALPATE. KNOW THE DIFFERENTIAL DIAGNOSIS OF SPLENOMEGALY. KNOW THE PITFALLS. IF YOUR CLINICAL SUSPICION REMAINS HIGH AFTER CLINICAL EXAMINATION PROCEED WITH A RADIOGRAPHIC STUDY.