d. Chest. Observe the shape of the patient's chest. The chest should be
e. Respirations. Respirations should be the result of movement of the
Palpation is touching the part of the patient's body you have just inspected and
becoming sensitive to what that body part feels like. It is possible to feel an abnormal
from a normal body part.
a. Four Uses for Palpation of the Chest.
(1) Identify areas of tenderness. Any area where the patient has reported
pain or where there are lesions (a hurt, injury, wound) should be palpated.
(2) Assess observed abnormalities. If you have seen masses or sinus
tracts (blind, inflammatory, tube-like structures opening into the skin), palpate the area
to evaluate the problem further.
(3) Further assess the respiratory excursion. Determine the range of
respiratory movement (how far the chest expands when he inhales and how far the
chest contracts when he exhales). You can also feel symmetry of respiratory
movement (whether or not the body parts feel the same on both sides during a
REMEMBER: 1 RESPIRATION =
(4) Elicit tactile fremitus. When a person speaks, vibrations that can be felt
are transmitted through the bronchopulmonary system to the chest wall. These
vibrations can best be felt when a person says the words "ninety-nine" or "one-one-
one." Ask the person to speak louder or lower his head if you cannot feel the vibrations.
b. Finger Placement. Place your finger pads on the skin surface over the area
you are palpating. Do not move your fingers over the skin surface during palpation.
Palpation should reveal a chest free from pain, tenderness, lesions, and masses. The
wall should be firm with no indication of rib fractures or abscesses. The trachea will be
midline; a deviated trachea is abnormal. Palpation of the respiratory excursion
(respiration at rest position) should reveal an even, symmetrical movement of the chest.