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What are the physical assessment techniques?
- Inspection
- Palpation
- Percussion
- Auscultation
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What is inspection?
- Observation
- General observation of the whole body, then specific body systems
- Assess symmetry ( compare both sides)
- Use your senses (visual, smell, hearing)
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What is palpation?
- Touch
- Use hands- Fingertips (most sensitive to fine tactile discrimination) ex for skin texture, swelling, pulses & lumps or masses.
- Use light palpation (1com) followed by deeper palpation
- Bimanual (use both hands to capture an organ) ex pelvic exam- uterus
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Why do we use percussion?
- Yielding a palpable vibration
- Percussion note changes reflect- location and size of organ, density( air, fluid, solid mass) superficial masses (< 5cm)
- Elicits pain (if inflammation present) - helpful in identifying a problem
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What are the different techniques of percussion?
- Direct- strike body directly. Ex precuss sinuses in an adult
- Indirect- 2-handed technique. Strike finger at DIP joint. Findings: Resonant, Hyperresonant, Tympany, Dull & Flat
- Direct or indirect percuss to find CVAT
- Deep tendon reflexes- use a reflex hammer
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How do you test for CVAT?
- Direct- use fist (ulnar surface) to precuss directly over CVA
- Indirect- Examiner places hand over patients CVA 7 then provides moderate force when striking his or her hand.
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What is Auscultation?
- Listening with stethoscope
- Tilt ear piece towards your nose
- Diaphragm (high pitched sounds)- breath sounds, bowel sounds, normal heart sounds
- Bell- low pitched/ soft sounds- rest bell gently on the skin to hear extra hear sounds & murmurs
- Warm end piece (rub, apply friction)
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