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Palpation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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