Download Palpation

Palpation
Palpation involves using the hands to examine parts of the body. This often starts by
feeling the pulse at the wrist (radial pulse). The doctor will then usually feel the part of
the body causing problems. Palpation is used to assess unusual warmth or coldness;
thickening; the nature of any lumps (e.g. solid, fluctuant, soft, hard, mobile, fixed), the
position where the heart beat is most easily felt on the chest wall, joint mobility and the
presence of peripheral pulses - especially in the lower limbs.
Examining different body systems
When examining a patient, the doctor may follow a structured approach that examines
each body system in turn. In many cases, however, it may be more appropriate for an
experienced doctor to just examine the system giving rise to symptoms.
Cardiovascular
Palpation: Palpation allows the doctor to assess the pulse rate, rhythm, volume and
nature of the radial pulse in the wrist. To feel the heart beat, the doctor will lay a hand on
the front of the chest, to the left to tell if it is weak, normal or heaving in nature. If the
heart is enlarged, the heartbeat will be felt further to the left than normal. Heart murmurs
may cause vibrations on the front or back of the chest wall which are known as thrills.
Respiratory
Palpation: Feeling the trachea in the neck will show whether it is in its normal central
position. An abnormality of one lung may push or pull the trachea to one side. The
doctor’s hands may be spread around the patient’s chest so the thumbs just meet in the
mid-line. The distance the thumbs are pulled apart when the patient takes in a deep breath
will show how effectively the chest can expand, and whether or not expansion is
symmetrical
Gastrointestinal
Palpation: Palpation of the abdominal system may start by looking at your tongue,
feeling for nodes in the neck, examining the places where hernias can form, feeling the
pulses at the top of the leg (femoral pulses. Examination of the abdomen is then
performed systematically in four quadrants to assess the size of organs such as the liver,
spleen and kidneys, and to feel for any masses. Gentle palpation will also reveal any
tenderness or protective contraction of abdominal muscles to guard against pain.
Nervous system
Palpation: Palpation over the muscles and joints is useful when assessing strength, the
ability to detect light touch, pressure, temperature, vibration sense, pinprick sensation and
how the big toe moves when the sole of the foot is lightly scratched. The doctor may also
grasp the big toe and move it up and down while the patients eyes are closed to see if the
movement can be detected. Palpating muscles and joints will help to assess the quality of
any tremor.