Karina

about 4 years ago

The spleen is mobile with respiration, whereas the kidneys is not. The kidney is "ballotable" whereas the spleen is not. The spleen has a notch on the anterior surface, and the kidney does not The spleen should be dull to percussion, where the kidney can be resonant due to overlying gas. Traube's space percussion: the sixth rib superiorly, the midaxillary line laterally, and the left costal margin inferiorly. This area should be dull on expiration. Middleton's manoeuvre:  The patient is asked to lie flat with his or her left fist under their back, at the left costovertebral angle. The examiner is positioned to the patient's left, facing the patient's feet. The fingers of both the examiner's hands are curled under the left costal margin, and the patient is asked to take a long, deep breath as the palpation of a descending spleen is sought. The spleen enlarges diagonally, towards the umbilicus and the RLQ, whereas the kidney enlarges inferiorly, to the ipsilateral pelvis. There is no palpable upper border to the spleen, whereas the kidney should have one There is a splenic rub on auscultation (whereas the kidney does not rub).

Spleen examination is a part of abdominal examination. Spleen is a lymphoid organ works as a filter for bugs, old cells and iron metabolism. It is present in the left hypochondrium right beneath the left costal margin. The patient is advised to lie supine on the examination table and advised to leave the abdominal wall loose while his knees are flexed. The examiner starts by asking if there is any tenderness in an area and avoid it till the very end of the examination. Then it is advised to start below the left hypochondrium . The fingers are pressed firmly in the skin to find the splenic edge. Examiner should move their examining hands higher slowly feeling for the spleen margin. Spleen and kidney can be differentiated of examination because spleen enlarges towards the right and kidney of palpable enlarges towards the pelvis in the same side.