Palpation (feeling) - the main clinical research method, which gives an idea about the properties of the studied organs and tissues, their sensitivity and topographic relations between them.
Depending on the purpose of the study palpation are different. When determining the temperature of body parts hand lay flat on the corresponding area of the body, the heart rate probes three bent fingers in the place where the artery is superficial, bone-lined (for example, a. radialis).
Superficial palpation is one or both hands, fingers extended, laid out flat Palmar surface to palpable parts of the body. Wide and shallow sliding movements, without pressure, consistently examined the planned area. Especially important superficial palpation is in the study of the abdomen. With this palpation revealed pain, tension of the abdominal wall, the increase some of the abdominal cavity organs (liver, spleen), the presence of a tumor running (see) and other
Deep palpation is used for a detailed study and more accurate localization of pathological changes. It is produced by one, three, four fingers, with more or less significant pressure. Types of deep palpation: methodological deep moving bimanual and jerky. Using a methodical sliding deep palpation (VP Samples, N. B. Strazhesko and C. X. Vasilenko), we are able to probe the individual organs of the abdominal cavity. Methodical it is called because palpation of the abdominal cavity is carried out in a specific sequence (see the Abdomen). Deep and moving - because this type palpation is necessary to penetrate deep into the abdominal cavity and to touch the body, pressed his fingers against her back, sliding movements of the hands, directed perpendicularly to the axis of the body.
Bimanual palpation is a special way of probing with both hands, in which the left hand of the investigated body is kept at a certain position or served to meet the right palpiruemam hand. Apply to palpation of the kidneys (see).
Jerky palpation is used for probing the liver or spleen when fluid accumulation in the abdominal cavity. Spend it as follows: three or four of extruded and pressed to each other finger of the right hand set perpendicular to the abdominal wall certain area. Then, without taking your fingers from the surface of the abdomen, make them a series of short and strong jolts, resulting in the ends of the fingers can touch the examined organ.
General rules palpation. Patients should be such provision as to achieve the greatest relax his muscles. Palmerait, based on the objectives of the survey, the various provisions of the patient (standing, sitting, lying). There is the knee-elbow position of the patient that you are most comfortable with the feeling of abdominal tumors and palpation in the tub for best relaxation of the muscles of the abdominal wall. Palpation of the abdominal cavity should be standing up and lying down.
The position of the examining doctor or medical assistant) should be comfortable, not causing stress and fatigue. His movements should be light, soft, not causing pain. Hands should be warm, nails they bobbed. Palpation of the abdomen, use of respiratory motion sick and manage them. For penetration into the depth of the abdominal cavity, use the expiratory phase, when the muscles of the abdominal wall relax. Penetration should be gradual, slow and careful. People with increased nervous irritability should divert calls to decreased observed they strengthened the muscles of the abdomen. To start palpation should with healthy sections, and always compare the affected side with healthy (comparative palpation). Palpation of the chest - see the Light.