Palpation is the process of using a person's hand to examine the body, especially when observing/diagnosing illness or disease. Usually performed by health care practitioners, it is the process of feeling objects inside or in the body to determine size, shape, firmness or location (for example, a veterinarian can feel the belly of a pregnant animal to ensure good health and successful delivery).
Palpation is an important part of physical examination; the sense of touch is equally important in this examination because of the sense of sight. Doctors develop great skills in dealing with problems beneath the surface of the body, being able to detect things that untrained people can not do. Mastery of anatomy and many exercises is required to achieve a high level of skill. The concept of being able to detect or see the subtle signs of touch and to recognize significance or implication is called appreciating them (as in the general vocabulary that can speak of appreciating the importance of something). However, some things are not palpable , which is why additional medical tests, such as medical imaging and lab tests, are often necessary to make a diagnosis. However, many other issues are being palpable. Examples include pulses, abdominal distension, heart sensations, fremitus, and various hernias, joint dislocations, fractures, and tumors, among others.
Video Palpation
Usage
Palpation is used by doctors, as well as chiropractors, massage therapists, physical therapists, osteopaths and occupational therapists, to assess the texture of the patient's tissues (such as swelling or muscle tone), to locate spatial coordinates of specific anatomical landmarks (eg, to assess the range and quality of joint motion ), and assessing tenderness through tissue deformation (eg provoking pain with pressure or stretching). In short, palpation can be used both to determine the area of ​​pain and to qualify the pain felt by the patient, or to find the three dimensional coordinates of the anatomical landmark to measure some aspects of the palpable subject.
Palpation is usually used for chest and abdominal examination, but may also be used to diagnose edema. Palpation is also a simple method for checking pulse rate. It is used by veterinarians to examine animals for pregnancy, and by midwives to determine the position of the fetus.
Quantitative palpation of anatomical landmarks for measurement must occur in accordance with strict protocols if one wishes to achieve reproducible measurements. The palpation protocol is usually based on well-defined definitions for anatomical locations, usually skeletal, landmarks.
Maps Palpation
Find anatomy marker
Finding anatomical markers can be done using two palpation protocols: 1) manual palpation that allows spatial landmark location by hand combined or not with three-dimensional (3D) digitalization, and 2) virtual palpation on the 3D computer model obtained , for example, from medical imaging.
Manual palpation skeletal landmark (illustrated here on the patient's shoulder, see left image). The palpable hand places a palpable landmark with satisfactory accuracy (below 1 cm). Reflective markers are part of the scientific protocol and allow for further motion analysis for follow-up joint disorders.
Virtual palpation from a skeletal landmark located on the 3D bone model (illustrated here on the patient's knee model obtained from medical imaging, see right image). The colored balls on the bones show a palpable skeletal bulge. This method combined with quantifiable manual palpation allows the subject-specific visualization of shared behavior during certain motion tasks (eg walking, climbing stairs, etc.).
The above protocols can be used independently. Manual palpation is used in clinical activities for a variety of purposes: - identification of pain areas; - positioning certain equipment (electrode electrode, auscultation, external markers used in clinical motion analysis or body surface scanning); or - measurement of morphological parameters (eg, limb length). Virtual Palpation alone is useful for measuring individual morphological parameters of medical imaging: - Length of extremities; - limb orientation; - Corner joints; or - the distance between the various skeletal locations.
Combining data from both virtual and manual palpation protocols enables achieving additional analysis: - registration protocols aimed at establishing a frame of reference for movement representation in accordance with reproducible clinical conventions; - to accurately model the kinematics of joints during musculoskeletal analysis; - To align orthopedic instruments appropriately according to the patient's individual anatomy; or - to wrap and scale the surface texture into motion data when creating animated characters.
The use of the standard definition for the above activities enables better comparison of results and exchange; this is a key element for patient follow-up or elaboration of clinical databases and quality research. Such a definition also allows for the ability of repetition acceptable to individuals of different backgrounds (physiotherapists, doctors, nurses, engineers, etc.). If applied strictly, this definition allows for better data exchange and comparison results thanks to standardization of procedures. Without the standardization of anatomical landmarks, palpation is prone to errors and poor reproduction.
Elastography
Currently, the modalities of elastographic medical imaging can also be used to determine tissue rigidity. Manpower palpation suffers from some important limitations: limited to networks accessible by the hands of doctors, it is distorted by any intervening network, and is qualitative but not quantitative. Elastography is able to overcome many challenges and increase the benefits of palpation.
Elastography is a relatively new technology and entered the clinic especially in the last decade. The most prominent technique uses ultrasound or magnetic resonance imaging (MRI) to create stiffness maps and anatomic images for comparison.
Palpate your computer
Although not widespread among elastographic methods, computer palpation is particularly interesting here because it basically uses palpation to measure stiffness, while other techniques will obtain data using other methods. Computerized Palpation also called "Tactile Imagery", "Mechanical Imaging" or "Stress Imaging", is a medical imaging modality that translates a sense of touch into digital images. The tactile image is a function P (x, y, z), where P is the pressure on the soft-tissue surface under the applied deformation and x, y, z is the coordinate at which the P pressure is measured. Tactile imaging closely mimics the palpation of the manual, since the probe of the device with its pressure sensor array mounted on its face acts similarly to a human finger during clinical examination, slightly damaging the soft tissue by the probe and detecting the resulting changes in the pressure pattern.
Palpation under general anesthesia
Palpation under general anesthesia is sometimes necessary, as when there is a need to feel the structure deep inside the abdominal or pelvic cavity, therefore it will cause sufficient patient discomfort and subsequent contractions of the abdominal muscles which will make the examination difficult. This is used, for example, in staging cervical cancer.
See also
References
Source of the article : Wikipedia
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