上海交通大学：《诊断学》课程PPT教学课件（英语版）Chapter 31 Palpation of the Abdomen

Palpation of the abdomen ⅹ UE Huiping

Palpation of the Abdomen XUE Huiping

e Palpation and percussion usually follow inspection in the examination of the other body systems as Following inspection, the examiner should perform auscultation of the abdomen

♣ Palpation and percussion usually follow inspection in the examination of the other body systems. ♣ Following inspection, the examiner should perform auscultation of the abdomen

This change in the order of examination is necessary because the auscultatory findings may be markedly altered by any manipulation of the abdominal wall. Consequently percussion and palpation, which may increase or decrease peristaltic sounds are deferred until auscultation has been completed

This change in the order of examination is necessary because the auscultatory findings may be markedly altered by any manipulation of the abdominal wall. Consequently percussion and palpation, which may increase or decrease peristaltic sounds, are deferred until auscultation has been completed

The final step in the abdominal examination is palpation. This procedure is usually the most important and often the most difficult to perform accurately

The final step in the abdominal examination is palpation. This procedure is usually the most important and often the most difficult to perform accurately

1.the principle of palpation a) To relax the patient

1. the principle of palpation a) To relax the patient

A For the patient: continue to lie supine with arms relaxed on the chest or at the sides may be further relaxed by instructing him to breathe slowly and deepl e For the examiner: 1)make certain that his hands are warm 2)assure the patient that he will make an effort not to cause discomfort and follow up this assurance 3)tackle with the ticklish patient

♣ For the patient: --- continue to lie supine with arms relaxed on the chest or at the sides --- may be further relaxed by instructing him to breathe slowly and deeply ♣ For the examiner: 1) make certain that his hands are warm 2) assure the patient that he will make an effort not to cause discomfort and follow up this assurance 3) tackle with the ticklish patient

A If the patient exhibits ticklishness, the examiner should disregard it and try to continue Cy If this Is proves unsuccessful, it i S useful to have the patient place his own hand on his abdomen. since this never tickles

♣ If the patient exhibits ticklishness, the examiner should disregard it and try to continue. ♣ If this proves unsuccessful, it is useful to have the patient place his own hand on his abdomen, since this never tickles

A The examiner may tentatively exert pressure on the abdomen through the patients own hand, and gradually increase the pressure, while assuring the patient that the examination will cause no discomfort

♣ The examiner may tentatively exert pressure on the abdomen through the patient’s own hand, and gradually increase the pressure, while assuring the patient that the examination will cause no discomfort

a When the patient has relaxed, the examiner again places his own hand on the abdomen and allows the patient to maintain contact with his hand this usually completes the relaxation of the ticklish patient, and the examination p roceeds as usual

♣ When the patient has relaxed, the examiner again places his own hand on the abdomen and allows the patient to maintain contact with his hand. This usually completes the relaxation of the ticklish patient, and the examination proceeds as usual

4)begins with gentle exploration of the abdominal wall and with no effort made to palpate deeply 5)As with inspection, the initial step in palpation may be facilitated by distracting conversation or questions regarding the history 6If the patient remains tense or if the abdominal wall is very muscular, better results may be obtained by having the patient flex the thighs and knees

4) begins with gentle exploration of the abdominal wall and with no effort made to palpate deeply 5) As with inspection, the initial step in palpation may be facilitated by distracting conversation or questions regarding the history. 6) If the patient remains tense or if the abdominal wall is very muscular, better results may be obtained by having the patient flex the thighs and knees