Palpation - wikipedia Palpation Not to be confused with palpitations. `` Palpable '' is not to be confused with `` palpebral ''. Palpation Palpation of a child 's abdomen MeSH D010173 MedlinePlus 002284 ( edit on Wikidata ) Look up palpation in Wiktionary, the free dictionary. Look up palpable in Wiktionary, the free dictionary. Palpation is the process of using one 's hands to examine the body, especially while perceiving / diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine its size, shape, firmness, or location ( for example, a veterinarian can feel the stomach of a pregnant animal to ensure good health and successful delivery ). Palpation is an important part of the physical examination ; the sense of touch is just as important in this examination as the sense of sight is. Physicians develop great skill in palpating problems below the surface of the body, becoming able to detect things that untrained persons would not. Mastery of anatomy and much practice are required to achieve a high level of skill. The concept of being able to detect or notice subtle tactile signs and to recognize their significance or implications is called appreciating them ( just as in general vocabulary one can speak of appreciating the importance of something ). Nonetheless, some things are not palpable, which is why additional medical tests, such as medical imaging and laboratory tests, are often needed to make a diagnosis. However, many other problems are palpable. Examples include pulses, abdominal distension, cardiac thrills, fremitus, and various hernias, joint dislocations, bone fractures, and tumors, among others. Contents 1 Uses 2 Locating anatomical landmarks 3 Elastography 3.1 Computerized palpation 4 Palpation under general anesthesia 5 See also 6 References Uses Palpation is used by physicians, as well as chiropractors, massage therapists, physical therapists, osteopaths and occupational therapists, to assess the texture of a patient 's tissue ( such as swelling or muscle tone ), to locate the spatial coordinates of particular anatomical landmarks ( e.g., to assess range and quality of joint motion ), and assess tenderness through tissue deformation ( e.g. provoking pain with pressure or stretching ). In summary, palpation might be used either to determine painful areas and to qualify pain felt by patients, or to locate three - dimensional coordinates of anatomical landmarks to quantify some aspects of the palpated subject. Palpation is typically used for thoracic and abdominal examinations, but can also be used to diagnose edema and to measure the pulse. It is used by veterinarians to check animals for pregnancy, and by midwives to determine the position of a fetus. Quantitative palpation of anatomical landmarks for measurements must occur according to strict protocols if one wishes to achieve reproducible measurements. Palpation protocols are usually based on well - described definitions for the location of anatomical, usually skeletal, landmarks. Locating anatomical landmarks Locating anatomical landmarks can be performed using two palpation protocols : 1 ) manual palpation that allows the spatial location of landmarks using hands combined or not with three - dimensional ( 3D ) digitizing, and 2 ) virtual palpation on 3D computer models obtained, for example, from medical imaging. Manual palpation of skeletal landmarks combined with 3D digitizing ( see text below for explanations ). Virtual palpation of skeletal landmarks. Manual palpation of skeletal landmarks ( illustrated here on a patient 's shoulder, see left image ). The gauntlet on the palpating hand ( left ) allows to locate the spatial coordinates of the palpated landmarks with a satisfactory accuracy ( below 1 cm ). Reflective markers are part of the scientific protocol and allow further quantified motion analysis for joint disorders follow - up. Virtual palpation of skeletal landmarks located on a 3D bone model ( illustrated here on a patient 's knee model obtained from medical imaging, see right image ). Colored spheres on bones indicate palpated skeletal landmarks. This method combined with quantified manual palpation allows subject - specific visualization of joint behavior during particular motion tasks ( e.g., walking, stair climbing, etc. ). The above protocols can be used independently. Manual palpation is used in clinical activities for various aims : - identification of painful areas ; - positioning of particular pieces of equipment ( electromyography electrodes, auscultation, external landmarks used in clinical motion analysis or body surface scanning ) ; or - measurements of morphological parameters ( e.g., limb length ). Virtual palpation alone is useful to quantify individual morphological parameters from medical imaging : - limb length ; - limb orientation ; - joint angle ; or - distance between various skeletal locations. Combining data from both manual and virtual palpation protocols allows achieving supplementary analysis : - registration protocols aiming at building reference frames for motion representation according reproducible clinical conventions ; - to modelize joint kinematics accurately during musculoskeletal analysis ; - to align precisely orthopedic tools according to the individual anatomy of a patient ; or - to wrap and to scale surface textures to motion data when creating animation characters. Use of standardized definitions for the above activities allows better result comparison and exchange ; this is a key element for patient follow - up or the elaboration of quality clinical and research databases. Such definitions also allow acceptable repeat ability by individuals with different backgrounds ( physiotherapists, medical doctors, nurses, engineers, etc. ). If applied strictly, these definitions allow better data exchange and result comparison thanks to standardization of the procedure. Without anatomical landmark standardization, palpation is prone to error and poorly reproducible. Elastography Conventional ultrasonography ( lower image ) and elastography ( supersonic shear imaging ; upper image ) of papillary thyroid carcinoma, a malignant cancer. The cancer ( red ) is much stiffer than the healthy tissue. Main article : Elastography Nowadays, the medical imaging modality of elastography can also be used to determine the stiffness of tissues. Manual palpation suffers from several important limitations : it is limited to tissues accessible to the physician 's hand, it is distorted by any intervening tissue, and it is qualitative but not quantitative. Elastography is able to overcome many these challenges and improve on the benefits of palpation. Elastography is a relatively new technology and entered the clinic primarily in the last decade. The most prominent techniques use ultrasound or magnetic resonance imaging ( MRI ) to make both the stiffness map and an anatomical image for comparison. Computerized palpation While not widespread amongst elastography methods, computerized palpation is of interest here because it essentially uses palpation to measure the stiffness, whereas other techniques will obtain data using other methods. Computerized palpation is also called `` Tactile Imaging '', `` Mechanical imaging '' or `` Stress imaging '', is a medical imaging modality that translates the sense of touch into a digital image. The tactile image is a function of P ( x, y, z ), where P is the pressure on soft tissue surface under applied deformation and x, y, z are coordinates where pressure P was measured. Tactile imaging closely mimics manual palpation, since the probe of the device with a pressure sensor array mounted on its face acts similar to human fingers during clinical examination, slightly deforming soft tissue by the probe and detecting resulting changes in the pressure pattern. Palpation under general anesthesia Palpation under general anesthesia is sometimes necessary, such as when there is a need to palpate structures deep in the abdominal or pelvic cavity, since it would otherwise cause considerable patient discomfort and subsequent contraction of the abdominal muscles which would make the examination difficult. It is used, for example, in the staging of cervical cancer. See also Physical examination Inspection ( medicine ) Percussion ( medicine ) Elastography Auscultation Motion analysis Medical imaging Tactile imaging References Jump up ^ http://dictionary.reference.com/browse/palpation Jump up ^ Van Sint Jan S, Della Croce U 2005 Identifying the location of human skeletal landmarks : why standardized definitions are necessary -- a proposal. Clinical Bio mechanics 20 : 659 - 660. Jump up ^ Pelvic examination under anesthesia at Uptodate. Author : William J Mann, Jr, MD. This topic last updated : Oct 8, 2012. Medical examination and history taking Medical history Chief complaint History of the present illness Systems review Nursing assessment Allergies Medications Past medical history Surgical history Family history Social history Psychiatric history Progress notes Mnemonics SAMPLE OPQRST SOAP COASTMAP Physical examination General / IPPA Inspection Auscultation Palpation Percussion Vital signs Temperature Heart rate Blood pressure Respiratory rate HEENT Oral mucosa TM Eyes ( Ophthalmoscopy, Swinging - flashlight test ) Hearing ( Weber, Rinne ) Respiratory Respiratory sounds Cyanosis Clubbing Cardiovascular Precordial examination Peripheral vascular examination Heart sounds Other Jugular venous pressure Abdominojugular test Carotid bruit Ankle - brachial pressure index Abdominal Digestive Liver span Rectal Murphy 's sign Bowel sounds Urinary Murphy 's punch sign Extremities / Joint Back ( Straight leg raise ) Knee ( McMurray test ) Hip Wrist ( Tinel sign, Phalen maneuver ) Shoulder ( Adson 's sign ) GALS screen Neurological Mental state Mini -- mental state examination Cranial nerve examination Upper limb neurological examination Neonatal Apgar score Ballard Maturational Assessment Gynecological Well - woman examination Vaginal examination Breast examination Cervical motion tenderness Assessment and plan Medical diagnosis Differential diagnosis Orthopedic examination General Straight leg raise Lasègue 's sign Gait abnormality Trendelenburg gait Unequal leg length Range of motion Palpation Leg Hip examination Galeazzi test Allis test Barlow maneuver Ober 's test Ortolani test Patrick 's test Thomas test Trendelenburg 's sign Knee examination Apley grind test Ballottement Clarke 's test Drawer test Lachman test McMurray test Patellar tap Pivot - shift test Wilson test Valgus stress test Foot & Ankle Hubscher 's maneuver Mulder 's sign Simmonds ' test Thompson test Arm Shoulder examination Apprehension test Jobe 's test Gerber 's test Hawkins -- Kennedy test Neer impingement sign O'Brien's test Speed 's test Yergason 's test Elbow examination Cozen 's test Elbow extension test Wrist & Hand Durkan 's test Finkelstein 's test Froment 's sign Lunotriquetral shear test Phalen maneuver Tinel sign Watson 's test Spine Gaenslen 's test Schober 's test Waddell 's signs Larrey 's sign Retrieved from `` https://en.wikipedia.org/w/index.php?title=Palpation&oldid=810107000 '' Categories : Physical examination Talk Contents About Wikipedia Deutsch Español Euskara Français Հայերեն Bahasa Indonesia Italiano Қазақша Кыргызча Nederlands Norsk Polski Português Русский Slovenčina Српски / srpski Svenska తెలుగు Українська Edit links This page was last edited on 13 November 2017, at 10 : 57. 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Question: which examination method do physicians use to determine the range of motion of a joint
Answer: Palpation