QAIS AL-AWQATI, M.B., CH.B.
AL-AWQATI Q. PERCUSSION OF THE LIVER. Ann Intern Med. 1969;71:868. doi: 10.7326/0003-4819-71-4-868_1
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Published: Ann Intern Med. 1969;71(4):868.
To the Editor: I would like to congratulate Drs. Castell, O'Brien, Muench, and Chalmers on a very interesting article in the June 1969 issue (1). I have, however, one reservation regarding the finding that hard percussion produced smaller estimates of liver size.
The percussion note is a vibration produced by the pleximeter finger. The character of the note is determined by the physical characteristics of the tissues set in vibration. The depth of travel of the vibration is proportional to its force of generation.
The cupola of the diaphragm (and therefore the liver) is present at the fourth intercostal space
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