Active Vocabulary. of little value-бесполезный

of little value-бесполезный

bulging - выпячивание

hypochondrium - подреберье

fullness - припухлость

epigastrium - надчревная область

costal margin -реберная дуга

of good tone - хорошо развиты

contour - очертание, контур

tenderness - болезненность

median line - медиана

hepatomegaly - гепатомегалия, увеличение печени

hepatic – печёночный

Inspection. Inspection of the area of the abdomen occupied by the liver is of little value unless the organ is enlarged.When the liver is greatly enlarged there may be bulging of the lower ribs in the right hypochondrium and fullness in the epigastrium below the right costal margin, with widening of the costal arch.

In a young child or in a thin adult it is sometimes possible to feel the sharp lower border of the normal liver be­neath the right costal arch and in the epigastrium, but as a rule, ifthe abdominal muscles are of good tone, muscular development prevents palpation of the lower hepatic border.

Palpation. Palpation of the liver supplemented by percussion demonstrates its contour, consistency and size and also reveals whether tenderness is present.

The contour and the consistency of the liver vary in different diseases. In the young child the liver is dispropor­tionately large. It extends well beyond the limits of the right hypochondrium. In the adult three quarters of the liver lie to the right of the median line.

Enlargements of the liver may be demonstrated in the following way: the upper abdominal zone may be palpated with the finger tips pointing upward toward the hepatic area. An enlarged liver may be felt to descend on deep inspi­ration and retract on deep expiration, hepatomegaly thus being distinguished from tumors not connected with the liver.