Examination of the gallbladder and liver - Revision history

wikademia>Wikademia: Text replace - '[[Topic:' to '[['

2009-06-08T03:54:29Z

Text replace - '[[Topic:' to '[['

← Older revision		Revision as of 03:54, 8 June 2009
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	-->{{#if:OSCE2\|{{Tnavbar2\|OSCE2\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}\|<!--		-->{{#if:OSCE2\|{{Tnavbar2\|OSCE2\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}\|<!--
	-->{{#ifeq:\|yes\|{{Tnavbar2\|{{PAGENAME}}\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}}}}}<!--		-->{{#ifeq:\|yes\|{{Tnavbar2\|{{PAGENAME}}\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}}}}}<!--
	-->'''[[~~Topic:~~Observed structured clinical examination\|Observed structured clinical examination]]'''</div><!--		-->'''[[Observed structured clinical examination\|Observed structured clinical examination]]'''</div><!--
	--><div class="NavContent" style="margin:0.5em; font-size:0.9em; text-align:left; ">		--><div class="NavContent" style="margin:0.5em; font-size:0.9em; text-align:left; ">
	<center>		<center>

wikademia>Wikademia: moved Examination of the Gallbladder and Liver (OSCE) to Examination of the gallbladder and liver

2009-04-26T13:44:30Z

moved Examination of the Gallbladder and Liver (OSCE) to Examination of the gallbladder and liver

← Older revision	Revision as of 13:44, 26 April 2009
(No difference)

wikademia>Wikademia at 01:57, 26 April 2009

2009-04-26T01:57:07Z

← Older revision		Revision as of 01:57, 26 April 2009
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	==Other OSCE modules==		==Other OSCE modules==
	{{~~Navigation~~		<!--
	~~\| name~~ = OSCE2		--><div class="NavFrame {{#ifeq:yes\|yes\|selected}}" style="clear:both; "><!--
	\| ~~title~~ = [[Topic:Observed structured clinical examination\|Observed structured clinical examination]]		--><div class="NavHead" style=""><!--
	~~\| show~~ = ~~yes~~		-->{{#if:OSCE2\|{{Tnavbar2\|OSCE2\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}\|<!--
	~~\| body =~~ <center>		-->{{#ifeq:\|yes\|{{Tnavbar2\|{{PAGENAME}}\|mini=1\|style=position:absolute;width:auto;left:0.5em;}}}}}}<!--
			-->'''[[Topic:Observed structured clinical examination\|Observed structured clinical examination]]'''</div><!--
			--><div class="NavContent" style="margin:0.5em; font-size:0.9em; text-align:left; ">
			<center>
	[[Acute Confusion (OSCE)\|Acute Confusion]] -		[[Acute Confusion (OSCE)\|Acute Confusion]] -
	[[Acute Coronary Syndrome Orders]] -		[[Acute Coronary Syndrome Orders]] -
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	[[Urinary Incontinence]]		[[Urinary Incontinence]]
	</center>		</center>
	}}
			<!--end_NavContent:--></div><!--
			<!---end_NavFrame:---></div>
	[[Category: Clinical Skills]][[Category:Gastroenterology]]		[[Category: Clinical Skills]][[Category:Gastroenterology]]
	{{ntnes}}		{{ntnes}}

wikademia>Wikademia at 01:56, 26 April 2009

2009-04-26T01:56:51Z

@@ Line 39: / Line 39: @@
 ==Other OSCE modules==
-{{OSCE2}}
+{{Navigation
 [[Category: Clinical Skills]][[Category:Gastroenterology]]
 {{ntnes}}

wikademia>Wikademia at 18:13, 11 April 2009

2009-04-11T18:13:10Z

← Older revision		Revision as of 18:13, 11 April 2009
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	{{OSCE2}}		{{OSCE2}}
	[[Category: Clinical Skills]][[Category:Gastroenterology]]		[[Category: Clinical Skills]][[Category:Gastroenterology]]
			{{ntnes}}

wikademia>Wikademia: 4 revisions

2009-04-11T05:47:35Z

4 revisions

← Older revision	Revision as of 05:47, 11 April 2009
(No difference)

70.83.81.118: /* GALLBLADDER */

2009-01-08T02:11:12Z

GALLBLADDER

← Older revision		Revision as of 02:11, 8 January 2009
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	*orient hand perpendicular to the costal margin feeling from medial to lateral below the right costal margin (feels bulbous, focally rounded mass that moves downward on inspiration)		*orient hand perpendicular to the costal margin feeling from medial to lateral below the right costal margin (feels bulbous, focally rounded mass that moves downward on inspiration)

	*'''Murphy’s sign (~~colecystitis~~)'''		*'''Murphy’s sign (cholecystitis)'''
	*place left hand with forefinger parallel to and at the RLCM and with thumb pressing on the intersection of the costal margin and the lateral border of the abdominal rectus muscle		*place left hand with forefinger parallel to and at the RLCM and with thumb pressing on the intersection of the costal margin and the lateral border of the abdominal rectus muscle
	**+ → pain elicited around the area pressed during a deep inspiration		**+ → pain elicited around the area pressed during a deep inspiration

wikademia>Donek at 00:39, 25 June 2008

2008-06-25T00:39:11Z

← Older revision		Revision as of 00:39, 25 June 2008
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	==Other OSCE modules==		==Other OSCE modules==
	{{OSCE2}}		{{OSCE2}}
	[[Category:~~Medicine~~]][[Category:~~OSCE~~]]		[[Category: Clinical Skills]][[Category:Gastroenterology]]

wikademia>Koppertone: /* AUSCULTATION */

2007-05-18T03:08:37Z

AUSCULTATION

← Older revision		Revision as of 03:08, 18 May 2007
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	*bruit (HCC, acute ETOH hepatitis, AV malformation)		*bruit (HCC, acute ETOH hepatitis, AV malformation)

			==Other OSCE modules==
	{{OSCE2}}		{{OSCE2}}
	[[Category:Medicine]][[Category:OSCE]]		[[Category:Medicine]][[Category:OSCE]]

wikademia>Koppertone: New page: ==Positioning== expose from nipples to pubis have patient lying supine on bed with knees flexed ==INSPECTION== (from foot of the bed) level of comfort, jaundice abdominal distension, ...

2007-05-17T23:06:08Z

New page: ==Positioning== *expose from nipples to pubis *have patient lying supine on bed with knees flexed ==INSPECTION== (from foot of the bed) *level of comfort, jaundice *abdominal distension, ...

New page

==Positioning==
*expose from nipples to pubis
*have patient lying supine on bed with knees flexed

==INSPECTION==
(from foot of the bed)
*level of comfort, jaundice
*abdominal distension, bulging flanks, visible abdominal mass
*prominent veins (caput medusae)

==PALPATION==
*patient relaxed and breathing slowly
*LIGHT palpation over entire abdomen, save tender areas to last
*DEEP palpation with finger tips, feel with inspiration, relocate during expiration

===LIVER===
*start in RLQ with the examining hand parallel to the rectus muscles, advance hand superiorly with expirations and anticipate the liver edge striking the forefinger on inspiration
*attempt to feel the surface of the liver
*describe: '''consistency, tenderness, nodularity, pulsations'''

===GALLBLADDER===
*orient hand perpendicular to the costal margin feeling from medial to lateral below the right costal margin (feels bulbous, focally rounded mass that moves downward on inspiration)

*'''Murphy’s sign (colecystitis)'''
*place left hand with forefinger parallel to and at the RLCM and with thumb pressing on the intersection of the costal margin and the lateral border of the abdominal rectus muscle
**+ → pain elicited around the area pressed during a deep inspiration

==PERCUSSION==
*measure at the same point in the respiratory cycle

*LOWER BORDER: start below the umbilicus and percuss upward at right MCL and mid sternal line to liver dullness
*UPPER BORDER (6th ICS in MCL): from lung resonance and percuss downward to liver dullness
*measure liver span (liver span is 10 at MCL, 6 at MSL)

==AUSCULTATION==
*hepatic friction rub (tumour, inflammation, infarct)
*venous hum (portal hypertension)
*bruit (HCC, acute ETOH hepatitis, AV malformation)

{{OSCE2}}
[[Category:Medicine]][[Category:OSCE]]