ENGLISH II Physical Examination

INSPECTION AND PALPATION TECHNIQUES

GROUP: #1
STUDENTS:

Cristhian Ambuludí Fárez

Andrea Asanza Ordoñez
Roberth Riofrío Escobar

PROFESSOR: Lic. Maribel Barreto

SEMESTER: 8 “A”

DATE: 23/ September /2019

 OBJECTIVE

•To determine your health status at the time of your visit and evaluate the
possible risk factors related to your physical, psychological and nutritional
health.
PHYSICAL EXAMINATION
 RULES OF INSPECTION

The patient is fully or partially exposed

Positioned at a distance of 2-3 steps from the doctor

Gradually turning the patient’s doctor examines him in direct and lateral illumination

Inspection the thorax is best done in a vertical position and the abdomen in the vertical and
horizontal
 Plan of patient’s
inspection

General Inspection
Inspection of
inspection of according
different parts
the patient systems
 INSPECTION

Estimation of general condition

 Position of the patient
 Gait
Concioussness
Facial Expression
Age
Habitus, Weight
 Consciousness

Deranged
Clear

 Cloudiness
 Stupor
 Sopor
 Coma
 Posture

Active Passive Forced

 Gait

Is a combination of the pose and movement during

walking
 Face

Fascies Pneumonica

Fascies asthamatica

Fascies tuberculous
Position and abnormalities of the eyes
and eyelids

Ptosis: Dropping of the upper lid (myasthenia gravis,

damage of oculomotor nerve, and damage to the
sympathetic nerve supply)

Exophthalmia: the eyeball protrudes forward. When

bilateral, it suggests the infiltrative ophthalmopathy of
Graves’ disease.

Periorbital oedema: because the skin of the eyelids is

loosely attached to underlying tissues, oedema tends to
accumulate there easily. Causes: allergy, myxoedema,
nephritic syndrome.
 SKIN

Color
Eruption
Elasticity
Edema
Temperature
Spine and extremities
 THE COMPREHENSIVE PHYSICAL EXAMINATION

Cardiovascular Abdomen: Genitalia and

system:
• Observation of jugular
venous pulsation
• Inspection, palpation and
of carotid pulsation.
• Inspection, palpation and
percussion of the
abdomen.
• Asses the liver and spleen
• Try to feel the kidneys
hernias in men:
• Examine the penis and
scrotal contents and check
for hernias
 THE COMPREHENSIVE PHYSICAL EXAMINATION

Lower extremities:

Musculoskeletal Nervous system:

Peripheral vascular system: palpate Assessing of muscle
system: Inspection the joints, check bulk, tone and
for varicose veins. their range of strength; sensation
motion. and reflexes.
PALPATION TECHNIQUES
Palpation is an important mainstay for assessment and treatment.

"You cannot feel what you do not know."

Precise Palpation as a Process

Palpating the Skin
Example: Posterior trunk

Technique Expectations

Skin quality Skin quality

Skin temperature Skin temperature

Skin consistency Skin consistency

Palpating bony edges
Technique The fingertip palpates perpendicular to the edge of the bone.

Expectations Hard consistency and a clearly defined border.

This figure is about Palpating the edge

of bone, demonstrated here on the
acromial angle.
Palpating bony prominences
Examples

Medial epicondyle of the humerus

Lister tubercle

Anterior superior iliac spine

Tibial tuberosity

Gerdy tubercle

Posterior superior iliac spine

External occipital protuberance

 Sacral spinous processes

Palpating the Edge of Muscles
A muscle edge is usually palpated with the muscle slightly tensed.
Palpating Blood Vessels (Arteries)
Examples

Brachial artery
Femoral artery
Anterior tibial artery
Occipital artery

Technique: A finger pad is placed flat and

with very little pressure over the presumed
position of the artery.
SIMPLE SENTENCES
 SIMPLE SENTENCES

A simple sentence contains only one independent clause.

An independent clause is a group of words that has a SUBJECT and a
VERB and can stand alone as complete thought.

These kinds of sentences have only ONE INDEPENDENT CLAUSE and

the DON’T CONTAIN SUBORDINATE CLAUSES.

They express only MAIN IDEA.

 PRESENT SIMPLE TENSE

AFFIRMATIVE P.P VERB COMPLEMENT

NEGATIVE P.P DON'T/ DOESN'T VERB COMPLEMENT

INTERROGATIVE DON'T/ DOESN'T P.P COMPLEMENT ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I don't work in a
Do I/ You/ we /they I work in a hospital. Do you work in a hospital?
hospital.

She doesn't work in a

He/ She/ It She works in a hospital. Does she work in a hospital?
Does hospital.
 PRESENT CONTINUOUS TENSE

AFFIRMATIVE P.P VERB TO BE VERB ING

COMPLEMENT
VERB TO BE +
NEGATIVE P.P VERB ING COMPLEMENT
NOT

INTERROGATIVE AM/ IS/ ARE P.P VERB ING COMPLEMENT+ ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I’m writing a clinical I’m NOT writing a Are you writing a clinical
I/ You/ we /they
Verb to be + v. history. clinical history. history?
ing She’s writing a clinical She ISN’T writing a Is she writing a clinical
He/ She/ It
history. clinical history. history?

AM/ IS/ ARE + NOT

 PAST SIMPLE TENSE
AFFIRMATIVE P.P VERB PAST COMPLEMENT

NEGATIVE P.P DIDN’T VERB COMPLEMENT

INTERROGATIVE DID P.P VERB COMPLEMENT + ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I didn't work in a
Did I/ You/ we /they I worked in a hospital. Did you work in a hospital?
hospital.

Did He/ She/ It She worked in a hospital.. She didn't work in a Did she work in a hospital?
hospital.
 PAST CONTINUOUS TENSE

AFFIRMATIVE P.P WAS/WERE VERB ING COMPLEMENT

WAS/ WERE+
NEGATIVE P.P VERB ING COMPLEMENT
NOT
INTERROGATIVE WAS/ WERE P.P VERB ING COMPLEMENT+ ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I WAS writing a clinical I’m NOT writing a Are you writing a clinical
I/ You/ we /they
Verb to be + v. history. clinical history. history?
ing She WAS writing a clinical She ISN’T writing a Is she writing a clinical
He/ She/ It
history. clinical history. history?

WAS/ WERE + NOT

 FUTURE TENSE

AFFIRMATIVE P.P WILL COMPLEMENT

NEGATIVE P.P WILL NOT/ WON’T VERB COMPLEMENT

INTERROGATIVE WILL P.P VERB COMPLEMENT + ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I/ You/ we /they I will learn a new speciality I will NOT learn a Will I learn a new speciality?
new speciality
WILL
She will learn a new She will NOT learn a Will she learn a new
He/ She/ It
speciality new speciality. speciality?
 FUTURE CONTINUOUS
AFFIRMATIVE P.P Will + be VERB ING
COMPLEMENT
NEGATIVE P.P Will + NOT + be VERB ING COMPLEMENT

INTERROGATIVE Will P.P+ BE VERB ING COMPLEMENT+ ?

AFFIRMATIVE NEGATIVE INTERROGATIVE

I will NOT be looking
I will be looking at the Will you be looking at the
I/ You/ we /they practice of surgery. at the practice of practice of surgery?
surgery.
WILL She will be buying an She will NOT be Will she be looking at the
He/ She/ It looking at the
oximeter. practice of surgery?
practice of surgery.