The Abdominal Exam


LSU Physician Champions - Dr. Daniel Raines and Dr. Kellen Jex


Palpation of the Size of the Liver


The exam should be begin with the patient supine, and the abdomen exposed. Begin to palpate the abdomen in the right lower quadrant. Asking the patient to take a deep breath during palpation can sometimes assist in palpating the liver edge. One will feel the edge of the liver “roll over” the fingers if it is palpable. Palpation should slowly progress cephalad until the costal margin is reached.



If palpation is not successful, the size of the liver may be percussed. Start to percuss the right chest in the midclavicular line, beginning in the approximate area of the third intercostal space. Light percussion should progress caudad until dullness is noted, which represents the upper liver edge. Resume percussion in the right lower quadrant, in the midclavicular line, in an area that is tympanic and progress cephalad. Dullness to percussion denotes the lower liver margin.


Palpation of the Size of the Liver