EXAMINATION OF LIVER

**EXAMINATION OF LIVER **

Anatomical Location and Surface Markings:

• The liver is located in the upper right quadrant of the abdominal cavity, below the diaphragm and above the stomach, small intestine, and right kidney.
• It is attached to the diaphragm by the falciform ligament and to the anterior abdominal wall by the coronary ligament.
• The surface markings of the liver include the costal margin, the xiphoid process, the umbilicus, and the right costal margin.

Physical Examination:

• Inspection: The liver is inspected for size, shape, and any visible scars or swellings.
• Palpation: The liver is palpated to assess its size, tenderness, and surface texture.
• Percussion: The liver is percussed to assess its size and border.
• Auscultation: The liver is auscultated to assess for any abnormal sounds.

Assessing Size, Tenderness, and Surface Texture:

• Size: The liver is assessed for its size in relation to the costal margin and xiphoid process.
• Tenderness: The liver is assessed for tenderness by gentle palpation.
• Surface Texture: The liver is assessed for its surface texture, including any nodules, scars, or irregularities.

Correlating Findings with Potential Liver Diseases:

• An enlarged liver may indicate liver disease, such as cirrhosis or hepatitis.
• Tenderness may indicate liver disease, such as hepatitis or liver abscess.
• Irregular surface texture may indicate liver disease, such as liver cancer or liver cirrhosis.

Types of Liver Disease:

• Cirrhosis: A condition in which the liver is scarred and has lost its ability to function properly. Types:

  • Alcoholic cirrhosis: caused by excessive alcohol consumption.
  • Hepatitis C cirrhosis: caused by hepatitis C virus infection.
  • Non-alcoholic fatty liver disease (NAFLD) cirrhosis: caused by excessive fat accumulation in the liver. Clinical Features:
  • Abdominal swelling and jaundice.
  • Fatigue and weakness.
  • Loss of appetite. Investigations:
  • Liver function tests (LFTs).
  • Imaging studies (e.g., ultrasound, CT scan). Management:
  • Abstinence from alcohol.
  • Medications to manage symptoms and prevent complications. Treatment:
  • Liver transplantation in severe cases.

• Hepatitis: Inflammation of the liver caused by viral infection. Types:

  • Hepatitis A: caused by hepatitis A virus (HAV) infection.
  • Hepatitis B: caused by hepatitis B virus (HBV) infection.
  • Hepatitis C: caused by hepatitis C virus (HCV) infection. Clinical Features:
  • Jaundice.
  • Fatigue and weakness.
  • Loss of appetite. Investigations:
  • Liver function tests (LFTs).
  • Imaging studies (e.g., ultrasound, CT scan). Management:
  • Medications to manage symptoms and prevent complications. Treatment:
  • Antiviral medications to treat HBV and HCV infections.

• Liver Cancer: Malignant tumor of the liver. Types:

  • Primary liver cancer: arising from the liver itself.
  • Secondary liver cancer: metastasizing from other parts of the body. Clinical Features:
  • Abdominal swelling and jaundice.
  • Fatigue and weakness.
  • Loss of appetite. Investigations:
  • Imaging studies (e.g., ultrasound, CT scan).
  • Biopsy to confirm diagnosis. Management:
  • Surgery to remove the tumor.
  • Ablation therapy to destroy the tumor. Treatment:
  • Chemotherapy and radiation therapy.

Homoeopathic Therapeutic Medicines:

• China: For liver congestion and jaundice.
• Phosphorus: For liver inflammation and hepatitis.
• Arsenicum album: For liver cirrhosis and ascites.
• Lycopodium: For liver tumor and liver cancer.
• Gelsemium: For liver weakness and fatigue.
• Nux vomica: For liver congestion and indigestion.
• Kali phosphoricum: For liver inflammation and hepatitis.