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Palpation is used as part of a physical examination
Physical examination

File:Reeve 978.jpgPhysical examination or clinical examination is the process by which a health care provider investigates the body of a patient for sign of disease....
 in which an object is felt (usually with the hands of a healthcare practitioner) to determine its size, shape, firmness, or location. Palpation should not be confused with palpitation
Palpitation

A palpitation is an abnormal awareness of the heart rate of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. It should not be confused with ectopic beat....
, which is an awareness of the beating of the heart.

ation is used by various therapists such as practitioners of medical doctors,chiropractic
Chiropractic

Chiropractic is a health care approach and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the vertebral column, under the hypothesis that these disorders affect general health via the nervous system....
, osteopathic medicine
Osteopathic medicine

Osteopathic medicine is a branch of the medicine profession in the United States, with some Doctor_of_Osteopathic_Medicine#International_practice_rights, including most Canadian provinces....
, physical therapists, and massage therapists
Massage

Massage is the practice of soft tissue manipulation with physical, functional, and in some cases psychological purposes and goals. The word comes from the French language massage "friction of kneading," or from Arabic massa meaning "to touch, feel or handle" or from Latin massa meaning "mass, dough"....
, to assess the texture of a patient's tissue (such as swelling or muscle tone), to locate the spatial coordinates of particular anatomical landmarks (e.g., to assess range and quality of joint
Joint

A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally....
 motion), and assess tenderness through tissue deformation (e.g.






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Palpation is used as part of a physical examination
Physical examination

File:Reeve 978.jpgPhysical examination or clinical examination is the process by which a health care provider investigates the body of a patient for sign of disease....
 in which an object is felt (usually with the hands of a healthcare practitioner) to determine its size, shape, firmness, or location. Palpation should not be confused with palpitation
Palpitation

A palpitation is an abnormal awareness of the heart rate of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. It should not be confused with ectopic beat....
, which is an awareness of the beating of the heart.

Uses

Palpation is used by various therapists such as practitioners of medical doctors,chiropractic
Chiropractic

Chiropractic is a health care approach and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the vertebral column, under the hypothesis that these disorders affect general health via the nervous system....
, osteopathic medicine
Osteopathic medicine

Osteopathic medicine is a branch of the medicine profession in the United States, with some Doctor_of_Osteopathic_Medicine#International_practice_rights, including most Canadian provinces....
, physical therapists, and massage therapists
Massage

Massage is the practice of soft tissue manipulation with physical, functional, and in some cases psychological purposes and goals. The word comes from the French language massage "friction of kneading," or from Arabic massa meaning "to touch, feel or handle" or from Latin massa meaning "mass, dough"....
, to assess the texture of a patient's tissue (such as swelling or muscle tone), to locate the spatial coordinates of particular anatomical landmarks (e.g., to assess range and quality of joint
Joint

A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally....
 motion), and assess tenderness through tissue deformation (e.g. provoking pain with pressure or stretching). In summary, palpation might be used either to determine painful areas and to qualify pain felt by patients, or to locate three-dimensional coordinates of anatomical landmarks to quantify some aspects of the palpated subject.


Palpation is typically used for thoracic
Chest

The chest is a part of the anatomy of humans and various other animals sometimes referred to as the thorax....
 and abdominal
Human abdomen

The human abdomen is the part of the body between the pelvis and the chest. Anatomically, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim....
 examinations, and this but can also be used to diagnose edema
Edema

File:Oedema.jpgEdema or Oedema , formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body....
 and to measure the pulse
Pulse

In medicine, a person's pulse is the throbbing of their artery. It can be palpated in any place that allows for an artery to be compressed against a bone, such as at the neck , at the wrist , behind the knee , on the inside of the elbow , and near the ankle joint ....
. It is used by veterinarians to check animals for pregnancy
Pregnancy

Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or Multiple birth....
, and by midwives
Midwifery

Midwifery is a health care profession where providers give prenatal care to pregnancy mothers, attend the Childbirth of the infant, and provide postpartum care to the mother and her infant....
 to determine the position of a fetus
Fetus

A fetus is a developing mammal or other viviparous vertebrate, after the embryonic stage and before childbirth. The plural is fetuses, or sometimes feti....
.


Quantitative palpation of anatomical landmarks for measurements must occur according strict protocols if one wishes to achieve reproducible measurements. Palpation protocols are usually based on well-described definitions for the location of anatomical, usually skeletal, landmarks.


Locating anatomical landmarks


Locating anatomical landmarks can be performed using two palpation protocols: 1) manual palpation that allows spatial location of landmarks using hands combined or not with three-dimensional (3D) digitizing, and 2) virtual palpation on 3D computer models obtained, for example, from medical imaging.


Manual palpation of skeletal landmarks (illustrated here on a patient's shoulder, see left image). The gauntlet on the palpating hand (left) allows to locate the spatial coordinates of the palpated landmarks with a satisfactory accuracy (below 1 cm). Reflective markers are part of the scientific protocol and allow further quantified motion analysis for joint disorders follow-up.
Virtual palpation of skeletal landmarks located on a 3D bone models (illustrated here on a patient's knee model obtained from medical imaging, see right image). Coloured spheres on bones indicate palpated skeletal landmarks. This method combined with quantified manual palpation allows subject-specific visualisation of joint behavior during particular motion tasks (e.g., walking, stair climbing, etc).



The above protocols can be used independently. Manual palpation is used in clinical activities for various aims: - identification of painful areas; - positinionning of particular pieces of equipment (electromyography
Electromyography

Electromyography is a technique for evaluating and recording the activation signal of muscles. EMG is performed using an medical instrument called an electromyograph, to produce a record called an electromyogram....
 electrods, auscultation, external landmarks used in clinical motion analysis
Motion analysis

Researchers, engineers,and technicians have come to rely on video cameras as non-invasive testing devices. In industrial, scientific, clinical, and academic environments, video cameras provide a method of evaluating motion and performance from a distance, without interference from sensors....
 or body surface scanning); or - measurements of morphological parameters (e.g., limb length). Virtual palpation alone is useful to quantify individual morphological parameters from medical imaging
Medical imaging

Medical imaging refers to the techniques and processes used to create s of the human body for clinical purposes or medical science .As a discipline and in its widest sense, it is part of biological imaging and incorporates radiology , radiological sciences, endoscopy, thermography, medical photography and microscopy ....
: - limb length; - limb orientation; - joint angle; or - distance between various skeletal locations.


Combining data from both manual and virtual palpation protocols allows achieving supplementary analysis: - registration protocols aiming at building reference frames for motion representation according reproducible clinical conventions; - to modelize joint kinematics accurately during muscuskeletal analysis; - to align precisely orthopeadical tools according to the individual anatomy of a patient; or - to wrap and to scale surface textures to motion data when creating animation characters.


Use of standardized definitions for the above activities allows better result comparison and exchange ; this is a key element for patient follow-up, or the elaboration of quality clinical and research databases. Such definitions also allow acceptable repeatability by individuals with different backgrounds (physiotherapists, medical doctors, nurses, engineers, etc). If applied strictly, these definitions allow better data exchange and result comparison thanks to standardization of the procedure. Without anatomical landmark standardization, palpation is prone to error and poorly reproducible.

See also

  • Physical examination
    Physical examination

    File:Reeve 978.jpgPhysical examination or clinical examination is the process by which a health care provider investigates the body of a patient for sign of disease....
  • Inspection (medicine)
    Inspection (medicine)

    In medicine, inspection is the thorough and unhurried visualization of the client. This requires the use of the naked eye.During inspection, the examiner observes:...
  • Percussion (medicine)
    Percussion (medicine)

    Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen....
  • Auscultation
    Auscultation

    Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope; based on the Latin verb auscultare "to listen"....
  • Motion analysis
    Motion analysis

    Researchers, engineers,and technicians have come to rely on video cameras as non-invasive testing devices. In industrial, scientific, clinical, and academic environments, video cameras provide a method of evaluating motion and performance from a distance, without interference from sensors....
  • Medical imaging
    Medical imaging

    Medical imaging refers to the techniques and processes used to create s of the human body for clinical purposes or medical science .As a discipline and in its widest sense, it is part of biological imaging and incorporates radiology , radiological sciences, endoscopy, thermography, medical photography and microscopy ....