PHYSICAL

EXAMINATION
Instructor: Meerub Shakil
PHYSICAL EXAMINATION
TECHNIQUES
 INSPECTION
 PALPATION
 PERCUSSION
 AUSCULATATION
INSPECTION
 Inspection involves using the senses of vision, smell, and hearing to observe and detect
abnormal findings.
 Although most of the inspection involves the use of the senses only, a few body systems
require the use of special equipment (e.g., ophthalmoscope for the eye inspection, an otoscope
for the ear inspection)
PALPATION
 Palpation consists of using parts of the hand to touch and feel for the following characteristics:
 Texture (rough/smooth)
 Temperature (warm/cold)
 Moisture (dry/wet)
 Mobility (fixed/movable/still/vibrating)
 Consistency (soft/hard/fluid filled)
 Strength of pulses (strong/weak/bounding)
 Size (small/medium/large)
 Shape (well-defined/irregular)
 Degree of tenderness
PALPATION TYPES
1. Light palpation: It should be very little or no depression (less than 1 cm). Use this
technique to feel for pulses, tenderness, surface skin texture, temperature, and moisture.
2. Moderate palpation: Depress the skin surface 1 to 2 cm (0.5 to 0.75 inch) with your
dominant hand, and use a circular motion to feel for easily palpable body organs and
masses.
3. Deep palpation: Surface depression is between 2.5 and 5 cm (1 and 2 inches). This allows
you to feel very deep organs or structures that are covered by thick muscle.
4. Bimanual palpation: Use two hands, placing one on each side of the body part (e.g., uterus,
breasts, spleen) being palpated. Use one hand to apply pressure and the other hand to feel
the structure.
PERCUSSION
Percussion involves tapping body parts to produce sound waves. These sound waves or
vibrations enable the examiner to assess underlying structures. Percussion has several different
assessment uses, including:
 Eliciting pain: Percussion helps to detect inflamed underlying structures. If an inflamed area is
percussed, the client’s physical response may indicate or the client will report that the area
feels tender, sore, or painful.
 Determining location, size, and shape: Percussion note changes between the borders of an
organ and its neighbouring organ can elicit information about location, size, and shape.
 Determining density: Percussion helps to determine whether an underlying structure is filled
with air or fluid or is a solid structure.
 Detecting abnormal masses: Percussion can detect superficial abnormal structures or masses.
Percussion vibration penetrates approximately 5 cm deep. Deep masses do not produce any
change in the normal percussion vibrations.
 Eliciting reflexes: Deep tendon reflexes are elicited using the percussion hammer.
AUSCULTATION
Auscultation is a type of assessment technique that requires the use of a
stethoscope to listen for heart sounds, movement of blood through the
cardiovascular system, movement of the bowel, and movement of air
through the respiratory tract. A stethoscope is used because these body
sounds are not audible to the human ear.