NR509
Week 2 -- HEENT & Respiratory
What is the order of the physical examination? - ANS inspection, palpation, percussion, and
auscultation
The physical examination includes inspection, palpation, percussion, and auscultation in that
order.
Describe Inspection: - ANS concentrated watching
It is close, careful scrutiny, first of the individual as a whole and then of each body system.
Train yourself not to rush through inspection by holding your hands behind your back.
Learn to use each person as his or her own control and compare the right and left sides of the
body. The two sides are nearly symmetric. Inspection requires good lighting, adequate
exposure, and occasional use of certain instruments (otoscope, ophthalmoscope, penlight,
nasal and vaginal specula)
The physical examination includes inspection, palpation, percussion, and auscultation in that
order.
Describe Palpation: - ANS Palpation applies your sense of touch to assess these factors:
texture; temperature; moisture; organ location and size; and any swelling, vibration or pulsation,
rigidity or spasticity, crepitation, presence of lumps or masses, and presence of tenderness or
pain.
palpation technique should be slow and systematic, calm and gentle
Start with light palpation to detect surface characteristics and accustom the person to being
touched. Then perform deep palpation, perhaps by helping the person use relaxation
techniques such as imagery or deep breathing.
The physical examination includes inspection, palpation, percussion, and auscultation in that
order.
Describe : Auscultation - ANS For low-frequency sounds (traditional bell mode), hold the end
piece very lightly on the skin;
, for high-frequency sounds (traditional diaphragm mode), press the endpiece firmly on the skin.
The physical examination includes inspection, palpation, percussion, and auscultation in that
order.
Describe Percussion: - ANS - tapping the person's skin with short, sharp strokes to assess
underlying structures through interpreting vibrations and characteristic sounds
-Percuss 2 times in each location using even staccato blows. Lift the striking finger off quickly; a
resting finger dampens vibrations.
With deep palpation (as for abdominal contents), what kind of pressure is superior? - ANS
intermittent is better than one long, continuous palpation.
Bimanual palpation definition: - ANS uses of both of your hands to envelop or capture certain
body parts or organs such as the kidneys, uterus, or adnexa for more precise delimitation
What 4 uses does percussion have?
Why use percussion compared to x-ray? - ANS • Mapping out the location and size of an organ
by exploring where the percussion note changes between the borders of an organ and its
neighbors
• Signaling the density (air, fluid, or solid) of a structure by a characteristic note
• Detecting an abnormal mass if it is fairly superficial; the percussion vibrations penetrate about
5 cm deep—a deeper mass would give no change in percussion
• Eliciting a deep tendon reflex using the percussion hammer
** x-rays are more accurate but your hands are always available, are easily portable, and give
instant feedback
What is the pleximeter? - ANS the middle finger
How does percussing over a bone always sounds?
How is this used clinically? - ANS "dull"
not used clinically - bone always sounds dull
*note that you are using your striking hand to hit your own middle finger (the pleximeter) on the
stationary hand. the "bone" referred to here is the patients
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