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Flashcards in Competency 2 Deck (4)
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1
Q

A) Light Palpation of Inanimate Objects

A

1) By touch try to distinguish Coins, Heads/ Tails, and Date line on coin
2) By palpation, outline a piece of hair with your fingertip and try to estimate its length under a sheet of paper
3) Outline the hair with your fingertip after adding sheets of paper until you can no longer palpate the hair
4) While palpating a human bone, identify its component parts and surface changes

2
Q

B) Light Layered Palpation of Human Tissues

A

1) Light palpates the non-dominant hand and note its contour
- Notes back of hand is more sensitive to temperature changes

2) Using very light touch, described skin texture, moisture, and thickness
- Rough or smooth
- Dry or Oily
- Spongy or boggy and edematous

3) Gently pinches the skin on the back of your hand. Elevate then release the skin, noting the time it took for the skin to resume its original shape
4) Slide fingertips across the surface of the skin noting any feel of “drag” along the finger tips
5) Locates the veins on hand, noting their size and texture
6) Locate the radial artery

7) Increases the contact between your palpating fingers and the skin of the hand, moving one tissue layer over another. creating a “shearing force” in the subcutaneous tissues
- Note how far were they are to feel the tissue shear before our fingers just started sliding on the skin?
- Move the tissue in all directions. Notes any asymmetries

8) Palpate the tensions on the ring finger and has patient flex and extend the finger noting the linear movement along the tendon
9) Palpates the Proximal and Middle Joints of your ring finger
10) Has patient FLEX and EXTEND the ring finger, noting the Articular surfaces and range of motion of the joint

3
Q

C) Moderate and Deep layered palpation of human tissues

A

1) Places the palm and fingers on dominant hand over the dorsal forearm of patient
2) Describes the skin temp, texture, thickness, and moisture
3) Compares the dorsal and palmar surfaces noting which is Smoother, Thicker, Warmer, and Drier

4) Using a slightly firmer touch, concentrates on the second layer os tissue- the SUBCUTANEOUS FASCIA
- Moves the skin in all directions noting thickness, looseness, and notes how easily it moves

5) Increases the depth of touch feeling the DEEP FASCIAL LAYER around the underlying structures noting Smoothness and Firmness
6) Palpate the deep fascial layer, moving the hand horizontally across the forearm to identify the layers of the muscles
7) Palpates the muscle layers noting if soft and compliant, elastic, and direction the muscle fibers run
8) Have your patient slowly open and close their hand. Notes the quality and range of motion created by contracting and relaxing the muscle
9) Continues to palpate while moving distal past the junction of the muscles at the wrist and palates the transition of the muscle tissue to the smooth, round, firm feel of the tendon

4
Q

D) Palpation of paravertebral tissues and Spinal Motion

A

1) Palpation of tissues, not through clothing
2) Performs in both a seated and prone position
3) Note any differences in the placatory findings between the positional changes
4) Locates the spinous process of T1, T2, T3, T4 on your partner with the pads of your palpating fingers
5) Notes C7 typically most prominent spinous process
6) Slides fingers off the bony processes inferiorly to feel the interspinous ligaments
7) Compares the difference of the bone of the spinous process and the fibrotic texture of the interspinous ligament
8) While palpating the spinous process and the interspinous ligaments, passively flex and extend your partner’s head noting the changes in tension of the spinous process
9) Lightly palpate and compress the paravertebral soft tissue from the cervical spine to the lower lumbar spine
10) Slowly increase the pressure to note the changes in compression ease in the different areas
11) Contact spinous process moving lateral to the transverse process of each of the vertebrae
12) Applies a LOADING and SPRINGING FORCE on TRANSVERSE PROCESS (TP) inducing segmental ROTATION prone and seated
13) Notes that pressing on right TP INDUCES ROTATION TO THE LEFT and vice versa
14) Note presence of HARD END-FEEL or not
15) If present on right TP, note the segment doesn’t want to rate to the left, thus a POSTERIOR TRANSVERSE PROCESS (PTP) on the right and that segment is RESTRICTED to LEFT ROTATION, and is considered to be ROATED RIGHT