Question

Give 5 examples each of the following:
1. Inspection
2. Palpation
3. Percussion
4. Auscultation

For health assessment class. Thank you

Answer 1

1) Inspection - Inspect each body system using vision, smell, and hearing to assess normal conditions and deviations. Assess for color, size, location, movement, texture, symmetry, odors, and sounds as you assess each body system.

Eg :1)  The anterior and posterior thorax is inspected for size, symmetry, shape and for the presence of any skin lesions and/or misalignment of the spine; chest movements are observed for the normal movement of the diaphragm during respirations.

2)  The abdomen is visualized to determine its size, contour, symmetry and the presence of any lesions. As previously mentioned, the abdomen is also inspected to determine the presence of any pulsations that could indicate the possible presence of an abdominal aortic aneurysm.

3) The extremities are inspected for any abnormal color and any signs of poor perfusion to the extremities, particularly the lower extremities. While the client is in a supine position, the nurse also assesses the jugular veins for any bulging pulsations or distention.

4) The major muscles of the body are inspected by the nurse to determine their size, and strength, and the presence of any tremors, contractures, muscular weakness and/or paralysis. All joints are assessed for their full range of motion. The areas around the bones and the major muscle groups are also inspected to determine any areas of deformity, swelling and/or tenderness.

5) The color, size, shape, symmetry, and any presence of drainage, flaring, tenderness, and masses are assessed; the nasal passages are assessed visually using an otoscope of the correct size for an infant, child and adult; the sense of smell is also assessed.

2) Palpation -  Palpation requires you to touch the patient with different parts of your hands, using varying degrees of pressure. Because your hands are your tools, keep your fingernails short and your hands warm. Wear gloves when palpating mucous membranes or areas in contact with body fluids. Palpate tender areas last.

Eg : 1) The posterior thorax is assessed for respiratory excursion and fremitus.

2) The peripheral veins are gently touched to determine the temperature of the skin, the presence of any tenderness and swelling.

3)  The muscles are palpated to determine the presence of any spasticity, flaccidity, pain, tenderness, and tremors.

4) Face and skull - The presence of any lumps, soreness, and masses are assessed.

5) Neck - The neck, the lymph nodes, and trachea are palpated for size and any irregularities.

3) Percussion - Percussion involves tapping your fingers or hands quickly and sharply against parts of the patient's body to help you locate organ borders, identify organ shape and position, and determine if an organ is solid or filled with fluid or gas.

Eg : 1)  For normal and abnormal sounds over the thorax.

2) Lung - For normal and abnormal sounds. Normal breath sounds like vesicular breath sounds, bronchial breath sounds, bronchovesicular breath sounds are auscultated and assessed in the same manner that adventitious breath sounds like rales, wheezes, friction rubs, rhonchi, and abnormal bronchophony, egophony, and whispered pectoriloquy are auscultated, assessed and documented.

3) Abdomen - Percuss the four quadrants of the abdomen to determine the amount of tympany and dullness .

4) Auscultation - The process of listening to sounds produced within the body. Auscultation may be direct or indirect. Direct auscultation is performed using the unaided ear, for example, to listen to a respiratory wheeze or the grating of a moving joint. Indirect auscultation is performed using a stethoscope, which transmits sounds to the nurse’s ears. A stethoscope is used primarily to listen to sounds from within the body, such as bowel sounds or valve sounds of the heart and blood pressure.

Eg : 1) Neck - When your doctor or healthcare provider is listening to your neck, they are often listening for a "swishing" sound in your arteries. This may suggest that there is a narrowing of the arteries, which would increase the sound of blood flow.

2) Heart: Normally, your heart produces a "lub-dub" sound, when the heart valves are opening and closing during the flow of blood. Your healthcare provider will listen to see if your heart is beating regularly, or if there are any murmurs (extra sounds with every heart beat). Heart murmurs may be "innocent", meaning they are normal, and non-life threatening, or they may signify a problem may be present.

3) Lungs: Your doctor or healthcare provider may listen to your lungs with their stethoscope, anywhere on your back (posterior), or on the front of your chest wall (anterior). He or she may be able to tell if air is moving to the bottom of your lungs, by listening to the airflow in and out of your lungs with each breath. These are called normal lung sounds. If there is a blockage, constriction or narrowing of your lung tubes, or fluid in your lungs, this can be heard by the examiner.

4)  Abdomen: The abdomen will be examined using a stethoscope, to listen for any "swishing" sounds of blood through the arteries near your stomach (such as the aorta), or abnormal bowel sounds.