Normally not palpable. Sometimes it is.
Surface = smooth and uniform.
Normal size by percussion=
< 5 cm in the RSB (right sternal border).
< 10 cm in the MCL (mid-clavicular line).
< 12 cm in the AAL (anterior-axillary line).

Border: Superior = 5th rib.
Mobility: Descends 1 to 3 cm, with deep inspiration.

Estimate:
  • Site
  • Shape
  • Volume
  • Surface
  • Mobility
  • Consistency
  • (nodular, hard-soft, irregular, granular, pulsatile).
  • Tenderness
  • Temperature
  • Megaly


  • Palpation Maneuvers
    1) "Bimanual" ("Chauffard"): left hand in costo-lumbar angle, right hand palpates parallel to the rectus.
    2) " Hooking" ("Mathieu"): Physician on the right side of the Patient (facing toward the Patient's feet), work the pulps of the fingers upward to the RUQ (right upper quadrant).
    3) "Glenard": left hand lifts the lumbar region, right hand palpates the RUQ.
    4) "Schmiedt": Physician behind the seated patient, liver descends with gravity.
    5) "Iceberg's sign" (ballottment): sudden pressure over the right hypochondrium, the liver rebounds -with hepatomegaly and ascites-.

    See the Abdomen page.