palpation
Last reviewed 01/2018
Palpation is used to determine five main clinical signs:
- the presence of lymphadenopathy:
- cervical and supraclavicular lymph nodes are particularly significant
- the position of the trachea:
- the trachea should be palpated deep in the supraclavicular notch to determine the position of the upper mediastinum
- the index finger is pressed deep in the suprasternal notch in the midline, if the trachea is not felt then the finger is inserted to one side or the other
- tracheal tug:
- the distance between the suprasternal notch and the cricoid cartilage is normally 2-3 fingers breadths
- a reduction in this distance, particularly on inspiration is a reliable sign of hyperinflation
- chest expansion:
- the examiner places the hands on either side of the chest over the upper and then lower zones
- observing the movement of the hands during respiration may demonstrate asymetrical expansion of the chest
- tactile vocal fremitus