MRCP UK EXAMINATIONS

Detailed explanation-1: -Palpation for splenic enlargement should begin with the patient supine and with knees flexed. Using the right hand, the examiner should begin well below the left costal margin and feel gently but firmly for the splenic edge by pushing down, then cephalad, then releasing (Figure 150.1).

Detailed explanation-2: -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.

Detailed explanation-3: -Three methods of Palpation (Supine Palpation Maneuver, Middleton’s Hooking Maneuver, Right lateral decubitus and supine) and three methods of Percussion (Traube’s space percussion, Nixon’s Maneuver, Castell’s Maneuver) will be performed on each patient by three different paediatrics residents.

Detailed explanation-4: -Normally, the spleen lies in the left upper quadrant and is quite posterior. Therefore, it is not always palpable. To palpate the spleen, place your right hand behind the patient’s inferior rib cage to support it. Then, use your left hand to palpate along the left costal margin.