Palpation

Question 1

Hand placing to assess breathing (apical)

Answer 1

Hand across sternum or either side of sternum

Question 2

Hand placement to assess breathing (abdominal)

Answer 2

Hand on upper abdomen just below xiphi sternum

Question 3

Hand placement to assess breathing (lateral costal)

Answer 3

Both hands either side of the chest on lower ribs or both hands on one side (anterior to posterior)

Question 4

What to palpate

Answer 4

Abdomen- any movements, any distension, chest expansion, trachea, sputum- crackles, tactile fremitus, vocal fremitus, pain, body temp, surgical emphysema, scars, response to touch

Question 5

What to look for when palpating abdomen

Answer 5

Close relationship with diaphragm, distended diaphragm inhibits diaphragmatic movements, restricts lung volumes and increases wob

Question 6

What to look for when palpating the trachea

Answer 6

Where is it in relation to sternal notch, deviation?

Question 7

What’s tactile fremitus

Answer 7

Transmission of crackles felt on the outside of the chest wall

Question 8

What’s vocal fremitus

Answer 8

Measures speech vibrations transmitted through the chest wall, increases when the underlying lung tissue is solid (consolidation) in some way and decreases in patients with pneumothorax effusions

Question 9

What to look for when palpating skin

Answer 9

Cold, clammy, hot, sweaty, hydration

Question 10

What to look for when palpating scars

Answer 10

Response to touch, cardiac and thoracic surgery injury, does pattern of breathing alter on palpation