L5: Palpation

Question 1

True / False. Palpation is means of using the hands to uncover and receive information while disrupting tissue

Answer 1

• False, no disrupting of tissue

Question 2

Types of motions

Answer 2

• Active: produced by pt
• Passive: produced by physician
• Inherent: spontaneous motion of cell, organ, system

Question 3

What is OSE? When is it completed? Types of evaluations?

Answer 3

• Osteopathic structural exam: exam by osteopathic physician with emphasis on NMS system including palpatory diagnosis for SD and viscerosomatic changes within context of total pt care.
• Completed after medical history and PEX
• 1.) Static evaluation (no motion), 2.) dynamic (motion – active or passive)

Question 4

Three cardinal steps in proper diagnosis and tx with OMM

Answer 4

1. ) Diagnosis
2. ) Treatment
3. ) Rechecking

Question 5

How to describe what is being palpated?

Answer 5

• TART
• T: tissue texture abnormality – vasodilation, edema, flaccidity, contraction, contracture (permanent contraction), fibrosis
• A: asymmetry
• R: restriction of motion
• T: tenderness

Question 6

Acute vs Chronic time frame and palpatory signs (pain, skin changes, vasculature, sympathetic activity, musculature, mobility, soft tissue, adnexa, visceral)

Answer 6

1. ) Acute (0-7 days to less than 3 months):
   - pain: severe, cutting, sharp
   - skin changes: warm, moist, red, inflamed
   - vasculature: vasodilation, inflammation and edema
   - SNS activity: local vasodilation
   - musculature: increased tone, contraction, spasm, ropy
   - mobility: ROM normal, quality sluggish
   - soft tissues: boggy edema, acute congestion
   - adnexa: moist, no trophic changes
   - visceral: minimal somatovisceral reflex effects
2. ) Chronic (more than 3 months):
   - pain: dull, achy, parasthesias
   - skin changes: cool, pale
   - vasculature: constricted
   - SNS activity: vasoconstricted
   - musculature: decreased, flaccid, mushy, limited ROM d/t fascial contracture
   - mobility: ROM diminished, quality normal
   - soft tissues: congestion, doughy, stringy, fibrotic, thickened, resistant to penetration, contractured, contracted
   - adnexa: scaly, dry, pimples, folliculitis
   - visceral: common somatovisceral reflex effects