Abdomen

• Scratch test - a technique that can be used to ascertain the location and size of the liver and spleen. This test can be particularly useful if the abdomen is tense (rigid or guarded), distended, obese, or too tender to palpate
• lower border of liver dullness is located at the costal margin 1-2 cm
• on deep inspiration, lower border of liver dullness may descend from 1 to 4 cm below the costal margin
• upper border of liver dullness is located between the left fifth and seventh intercostal spaces
• A second method for detecting splenic enlargement is to percuss the last left interspace at the anterior axillary line (AAL) while the client takes a deep breath