Palpation Introduction Presentation Slides PDF

PT 6620: Clinical Procedures Spring 2025 Palpation Introduction PT 6620: Clinical Procedures Palpation: To Touch Palpation Intro 1 PT 6...

PT 6620: Clinical Procedures Spring 2025 Palpation Introduction PT 6620: Clinical Procedures Palpation: To Touch Palpation Intro 1 PT 6620: Clinical Procedures Spring 2025 Palpation: To Touch If done right… Can build rapport Establish confidence Powerful examination tool Make interventions more precise Palpation  2 MAIN PURPOSES 1. IDENTIFY structures 2. EXAMINE structures Palpation Intro 2 PT 6620: Clinical Procedures Spring 2025 Skin Others… Bones Bursae Muscles IDENTIFY Vasculature Tendons Nerves Ligaments Tenderness Others… Temp. Movement Size EXAMINE Alignment/ Pulses Relation Tension/ Quality/ Tone Defects Palpation Intro 3 PT 6620: Clinical Procedures Spring 2025 Tissues  Additional Specifics Skin Bones Muscles Tendons Ligaments Nerves Vasculature Bursae Other… Tissues  Additional Specifics Skin Mobility Bones Scarring Muscles Tendons Hydration Ligaments Fragility Nerves Temperature Vasculature Edema/effusion Bursae Trophic changes Other… Etc Palpation Intro 4 PT 6620: Clinical Procedures Spring 2025 Tissues  Additional Specifics Skin Continuity Bones Road map to other Muscles structures Tendons Tenderness at Ligaments attachments Nerves Vasculature Bursae Other… Tissues  Additional Specifics Skin Contract to… Bones Find Muscles Examine quality Tendons of contraction Ligaments Relax to… Nerves Examine quality Vasculature of tissues Bursae Examine resting tone Other… Palpation Intro 5 PT 6620: Clinical Procedures Spring 2025 Tissues  Additional Specifics Skin Bones Muscles Found by alternating Tendons relaxing/contracting Ligaments of the attached muscle Nerves Vasculature Bursae Other… Tissues  Additional Specifics Skin Bones Muscles Tendons Ligaments Can produce Nerves paresthesias when Vasculature palpated Bursae Other… Palpation Intro 6 PT 6620: Clinical Procedures Spring 2025 Tissues  Additional Specifics Skin Bones Muscles Tendons Press too hard Ligaments Nerves Occlusion Vasculature Bursae No pulse Other… Tissues  Additional Specifics Skin Cannot feel unless Bones inflamed Muscles When inflamed, Tendons they feel “boggy” Ligaments Nerves Vasculature Bursae Other… Palpation Intro 7 PT 6620: Clinical Procedures Spring 2025 Palpation Types Flat Point Pincer Snapping/ Rolling Layer Palpation Process Questions What contacts do you use? How many fingers do you use? How hard do you push? Too soft? Too hard? How do you decide what to palpate and in what order? Palpation Intro 8 PT 6620: Clinical Procedures Spring 2025 Palpation Process Questions What contacts do you How many fingers do you use? use? Depends on target Depends on size/depth tissue… of target tissue Pads of fingers Larger target  More (preferred to Smaller target  Less tips or thumb) Entire hand Dorsum of hand Best for temperature Palpation Process Questions How hard do you push? What if too soft? “It Depends…” Palpation Intro 9 PT 6620: Clinical Procedures Spring 2025 Palpation Process Questions How hard do you push? What if too hard? “It Depends…” Palpation Process Questions How hard do you push? If your fingernails “It Depends…” blanch, you are likely pushing too hard… Confident & Purposeful Pressure Start lighter  firmer PRN Palpation Intro 10 PT 6620: Clinical Procedures Spring 2025 Palpation Process Questions How do you decide what to palpate and in what order? Systematic Have a goal/purpose in mind Magee text has a good system… but not the only one Uninvolved side first Painful areas last??? Palpation: Tips Movement is easier to sense than static If target tissue is If target tissue is stationary... move your moving… hold your hands across it hands still Consider active vs Movement “away” is passive movement typically more sensitive Movement “perpendicular” to the structure is typically more sensitive Palpation Intro 11 PT 6620: Clinical Procedures Spring 2025 Palpation: Tips What do you need to be good? (part1) Build/maintain rapport Patient in relaxed/supported position Get Consent Invite questions/feedback Ease into the process and the pressure Talk patient through it Palpation: Tips What do you need to be good? (part2) Familiarity Visualize Focus Practice Hands need to talk to you Hair/Thread in a book State quarters Palpation Intro 12 PT 6620: Clinical Procedures Spring 2025 Palpation: Documentation Descriptive “Pt was tender to palpation (TTP) at …” “Noted increased tension at …” “Noted calor at…” “Noted taut band at…” Palpation: Documentation Grading Tenderness:* Grade I: Patient complains of pain Grade II: Patient complains of pain and winces Grade III: Patient winces and withdraws the body part Grade IV: Patient will not allow palpation of the body part *Magee; Orthopedic Physical Assessment 7e Palpation Intro 13 PT 6620: Clinical Procedures Spring 2025 Lab Objectives and Process Goal is to help you Improve “listening” to your hands Identify selected structures Order based on region/proximity/flow Not the only way Magee chapters  Orthopedics Course Within regions Bony structures first… Why? Soft tissue structures second Lab Objectives and Process For tomorrow: Dress in accessible lab clothes Review and bring lab handouts May want to bring an anatomy atlas Palpation Intro 14