Asterixis on Physical Exam Asterixis, aka liver flap, indicates at least Grade 2 hepatic encephalopathy in a patient with cirrhosis due to a combination of 1. Hypotonia - cannot maintain extended outstretched hands at wrist 2. Myoclonus - fall of the hands from the extended position broken up to segments - “bat’s wing” or flapping tremors Dr. Martín @martinfd78 via Dr. Keith Siau @drkeithsiau #Asterixis #PhysicalExam #clinical #video #cirrhosis #flap #neurology
