2. Inspection and palpation of the liver

2. 1. Study the vocabulary to the text (Изучите лексику к тексту)

of little value ['vxljH] – бесполезный

bulging ['bAldZIN ] – выбухание

hypochondrium [ֽhaIpq'kOndrIqm ] – подреберье

fullness ['fHlnIs] – припухлость

epigastrium [qpI'gxstrIqm ] – надчревная область

costal margin ['mRGIn ] – реберная дуга

of good tone – хорошо развиты

contour ['kOntuq] – очертание, контур

tenderness ['tendqnIs ] – болезненность

median line ['mJdIqn] – медиана

hepatomegaly [ֽhIpqtq'megqlI ] – гепатомегалия, увеличение печени

hepatic [hI'pxtIk ] – печёночный

2. 2. Read and translate the text (Прочитайте и переведите текст)

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, if the 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.

2. 3. Find the translation of the following phrases in the text

(Найдите перевод следующих фраз в тексте)

1. область брюшной полости

2. если только орган не увеличен

3. сильно увеличена

4. нижние рёбра

5. прощупать острую нижнюю границу

6. дополненная перкуссией

7. при разных заболеваниях

8. выходит далеко за границы

9. три четверти печени

10. можно доказать

11. кончиками пальцев

12. вверх по направлению к печёночной области

13. можно почувствовать, как увеличенная печень опускается

14. возвращается назад при глубоком выдохе

15. распознаётся между

2. 4. Agree or disagree (Согласитесь или возразите)

1. Inspection of the area of the abdomen occupied by the liver is very important unless the organ

is enlarged.

2. In a young child or in a thin adult it is not possible to feel the sharp lower border of the normal

liver be­neath the right costal arch and in the epigastrium.

3. If the abdominal muscles are of good tone, muscular development prevents palpation of the

lower hepatic border.

4. Palpation of the liver can't reveal whether tenderness is present.

5. The contour and the consistency of the liver is the same in different diseases.

6. In the young child the liver is disproportionately large.

7. In the adult three quarters of the liver lie to the left of the median line.