Palpation , Biology

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Palpation:
Use the ball of one hand  and move the hand  from one side of the posterior thorax to other. Note presence of swelling, masses, muscle tone, fremitus and crepitation. Fremitus is a vibration that can be  felt by  the hand through the chest wall. Ask the patient to  speak in a normal tone of voice, repeating "99"  or "1,  2, 3"  while you palpate the chest. Increased vibration near the  large bronchi is normal. In other areas, an increased fremitus is indicative of increased density of lung tissue which  is  seen in consolidation of  lung, lobar pneunomia and pulmonary oedema. Decreased fremitus is normal  in patient who
has a soft voice.  In other cases, it  indicates obstruction of air flow into a portion of lung, pleural effusion, hemothorax, pneumothorax or a bronchial obstruction.

Crepitatoin is a  tactile sensation or a coarse, crackling sound produced by  the compression of skin with air  in the underlying subentaneous tissue see in patients with  aurgical emphysema or chest trauma  (air  leak  into subcentarcons tissue). 

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Palpate the  trachea  to see it  is  located in  a midline position  in  the neck. Tracheal deviation can occur on atilectasis, pneumonectomy, mediastinal mass, large pleural effusion, tension pneuthorax, unilateral emphysema and neck tumor

 


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