Question

Activity D CRITICAL THINKING ACTIVITIES 1. When might you use deep palpation during a physical examination? Bimanual palpation? Direct percussion? Indirect percussion? 2. Explain how the universal precautions (see Box 3-1, pp. 41–43 in textbook) and infection control guidelines would apply to the physical examination techniques of inspection, percussion, palpation, and auscultation. 3. Describe how you would prepare yourself to perform a total physical examination of a client of the opposite sex. Describe how you would prepare the client both emotionally and physically. 4. Mr. SM, a 60-year-old Hispanic man, comes to the ER in a wheelchair being pushed by his son. He states “I just fell off a step ladder in my garage and cannot walk.” 46 How would you use the following physical assessment techniques to gather more data on Mr. SM’s legs and feet? • Inspection • Percussion • Palpation • Auscultation Compare your answers with a lab partner.

Answer 1

1). During the physical examination, the deep palpation technique is generally used only during the assessment of abnormalities in the abdominal region. The technique is same for both the deep and light palpation, but in deep palpation, skin is most deeply pressed, the depth ranges from 2.5 to 5 cm. In case of light palpation, the depth is usually 1-2 centimeters and it is preferred to assess swelling, crepitation, pain in a particular region, and to determine the range of movement.

Bimanual palpation includes using both the hands to locate and observe particular body parts or organs such as liver, spleen, uterus, ovaries, kidneys, and others to examine their size and shape.

Percussion means, tapping the body to identify the vibratory sensations, for example, the percussion of the chest to examine the presence of fluids in the lung. In the direct percussion method, one hand is used to strike the body wall to produce a sound. Whereas the indirect percussion is done by using both the hands, which produces a subtle vibration.