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PHYSICAL EXAMINATION OF THE SPLEEN

PHYSICAL EXAMINATION OF THE SPLEEN. EXAMINATION OF THE SPLEEN. PERCUSSION PALPATION INSPECTION? AUSCULTATION?. COMPLIMENTARY. THE SPLEEN. 10 TH RIB. SPLEEN. EXAMINATION OF THE SPLEEN.

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PHYSICAL EXAMINATION OF THE SPLEEN

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  1. PHYSICAL EXAMINATION OF THE SPLEEN

  2. EXAMINATION OF THE SPLEEN • PERCUSSION • PALPATION • INSPECTION? • AUSCULTATION? COMPLIMENTARY

  3. THE SPLEEN 10TH RIB SPLEEN

  4. 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.

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

  6. 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

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

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

  9. 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.

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