Inspection
Purpose: Visual assessment for any abnormality before touching the patient.
General Rules:
- Always start with inspection before palpating or percussing.
- Use adequate lighting (natural light preferred).
- Expose the area properly while maintaining patient privacy.
- Compare both sides of the body to detect asymmetry.
Palpation
Purpose: Use hands to gather more information about skin, organs, and underlying structures.
Guidelines:
- Wash and warm your hands before palpation.
- Use the pads of your fingers (not tips).
- Observe patient’s face for discomfort.
- Always ask before palpating a tender area.
Assess for:
- Temperature – use the dorsum of hand; increased in inflammation, decreased in ischemia.
- Tenderness – pain on touch or pressure (can indicate infection, inflammation).
- Texture – smooth, rough, scaly skin.
- Swelling or masses:
- Size, shape
- Consistency – soft, firm, hard
- Mobility – fixed vs. mobile
- Pulses – radial, femoral, dorsalis pedis etc. (note rate, rhythm, volume)
- Organ borders – liver edge, spleen tip, kidney borders
- Lymph nodes – location, size, tenderness, mobility
Special Palpation Techniques:
- Light vs. deep palpation – superficial for skin/tenderness, deep for organs/masses
- Rebound tenderness – sudden pain when pressure is released (peritonitis)
- Crepitus – crackling under skin (gas or bone fragments)