Physical Examination Techniques (Palpation (Types, Hand Part,…
Physical Examination Techniques
-Place the middle finger of your nondominant hand on the body part you are going to percuss.
-Keep your other fingers off the body part being percussed because they will damp the tone you elicit.
-Use the pad of your middle finger of the other hand (ensure that this fingernail is short) to strike the middle finger of your nondominant hand that is placed on the body part.
-Withdraw your finger immediately to avoid damping the tone.
-Deliver two quick taps and listen carefully to the tone.
-Use quick, sharp taps by quickly flexing your wrist, not your forearm.
Observe before touching
Expose body part being inspected while covering the rest
Watch for patterns, size, location, consistency, symmetry, movement, behavior, odors, or sounds
Check for symmetry in body
Comfortable room temperature
Consistency (soft/hard/fluid filled)
Strength of pulses (strong/weak/thready/bounding)
Shape (well defined/irregular)
Degree of tenderness
: pulses, texture, size, consistency, shape, crepitus
Good lighting (sunlight)
: pulses, tenderness, surface skin texture, temperature, and moisture (less than 1cm)
: Body organs\ masses 1 to 2 cm (0.5 to 0.75 inch)
: Use two hands, placing one on each side of the body part
: Very deep organs or structures that are covered by thick muscle2.5 and 5 cm (1 and 2 inches)
Determining location, size, and shape
Detecting abnormal masses
: Direct tapping of a body part with one or two fingertips to elicit possible tenderness
: Detect tenderness over organs (e.g., kidneys) by placing one hand flat on the body surface and using the fist of the other hand to strike the back of the hand flat on the body surface
: Produces a sound or tone that varies with the density of underlying structures
High pitch sounds (press firmly)
Ex: normal heart sounds, breath sounds, bowel sounds
low-pitched sounds (hold lightly)
abnormal heart sounds and bruits (abnormal loud, blowing, or murmuring sounds)