METHODS OF
PHYSICAL
EXAMINATION
DEFINITION OF PHYSICAL
EXAMINATION
➢Physical Examination is defined as a
complete Assessment of a patient’s
physical and mental status
➢Physical assessment is a systematic
collection of objective information that
is directly observed or elicited through
examination technique.
DEFINITION OF PHYSICAL
EXAMINATION
•Physical
examination is a
systematic data
collection method
that uses the
PURPOSE OF PHYSICAL
EXAMINATION
• To understand the physical and mental well-
being of the patient.
• To detect disease in its early stage
• To determine the cause and the extend of
disease
• To understand any changes in the condition
of disease, any improvement or regression.
• To determine the nature of the treatment or
nursing care needed for the patient.
METHODS OF PHYSICAL
EXAMINATION
INSPECTION
PERCUSSION
PALPATION
AUSCULTATION
OLFACTION
DEFINITION
• It is a deliberate,
purposeful and
systematic collection
of data fromthe
client through the
visual examination
(that is, assessing by
usingthe sense of
sight)
GUIDELINES OF INSPCTION
• Make sure that adequate
lighting is available ,either
direct or tangential.
• Uses direct light sources
(eg., a penlight or lamp) to
inspect body cavities.
• Inspect each area for size,
shape, color, symmetry,
position, and abnormality.
GUIDELINES OF INSPCTION
• Position and expose
body parts as needed
so all surfaces can be
viewed but privacy can
be maintained.
• When possible, check
for side-to-side
symmetry by
comparing each area
with its match on the
opposite side of the
body
• Palpation is the
process of using
one's hands to
check the body,
especially while
perceiving
/diagnosing a
disease or
illness.
PURPOSE OF PALPATION
• Examination of the body surface (skin,
smoothness, dryness, irregularities
etc…)
• Examination of internal organs (shape,
size, consistency etc…)
• To look for abnormal resistances.
• Detection of painful areas
• To feel movement of fluids within the
body.
PRINCIPLES OF PALPATION
• Prepare for palpation by warming hands,
keeping fingernails short, and using a
gentle approach.
• Palpation proceeds slowly, gently, and
deliberately.
• Encourage the patient continue to
breath normally through out the
palpation.
• Ask the patient to point to more
sensitive areas.
PRINCIPLES OF PALPATION
• Ask the patient to point to more
sensitive areas.
• Watching for nonverbal signs of
discomfort.
• If the pain is experiencd during
palpation discontinue the palpation
immediately.
TYPES OF PALPATION
• LIGHT
PALPATION
• DEEP
PALPATION
LIGHT PALPATION
A method of
determining the
outlines of organs
or masses by
lightly palpating the
surface with the tip
of a finger for 1 to 2
centimeter.
DEEP PALPATION
• Deep
palpation is
used to feel
internal organs
and masses,
usually
pressing down
4-5 centimeters.
• Percussion is a methodof
tapping the skin with the
fingertips to vibrate
underlying tissues and
organs, to determine the
structure.
TYPES OF PERCUSSION
Direct percussion
Indirect percussion
Fist percussion
Direct percussion:-
It involve tapping lightly with the pad
of the fingers directly on the client
skin
Indirect percussion:-
• It can be performed
by using two finger left
middle
finger[Pleximeter
finger] is placed over
the area and its middle
phalanx is tapped with
the tip of the right
middle finger or index
finger [percussing
finger]
Fist percussion:-
• It involve placing
one hand flat
against the body
surface and striking
the back of the
hand with a
clenched fist of the
other hand
• Auscultation is
listening to the
internal sounds of
the body, usually
using a
stethoscope.
PURPOSE OF AUSCULATION
• Auscultation is
performed for the
purposes of examining
the circulatory and
respiratory systems, as
well as the
gastrointestinal system.
• Its helps to listening for
body sounds typically
from organs and tissues
to assess their
functions.
TYPES OF AUSCULTATION
Direct Indirect
auscultation Auscultation
Direct Auscultation
• It involve
listening to the
client body sound
without using any
assistive
instrument [eg
wheezing, chest
congestion]
Indirect Auscultation
• Involve
listening to
the client
body sound
with the use
of a
stethoscope
• Another skill that
used during
assessment, certain
alteration is body
function create
characteristic body
odors, smelling can
detect abnormalities
that unrecognized
by other means.
Assessment of characteristic
odors:
• Alcohol odor from oral cavity means
ingestion of alcohol.
• Ammonia from urine means urinary tract
infection.
• Body odor from skin, particularly in
areas where body parts rub together
means poor hygiene, excess
perspiration (bromidrosis).
Assessment of characteristic
odors:
• Feces odor from wound site means
wound abscess, but if this odor from
vomitus this means bowel obstruction,
and if the odor from rectal area this
means fecal incontinence.
• Foul–smelling stools in infant from
stool means mal absorption syndrome.
• Halitosis from oral cavity means poor
dental and oral hygiene, gum disease.
Assessment of characteristic odors
• Halitosis from oral cavity means poor
dental and oral hygiene, gum disease.
• Sweet, fruity ketone from oral cavity may
be from diabetic acidosis.
• Musty odor from casted body part means
infection inside cast.
• Fetid odor from tracheostomy or mucous
secretions means infection of bronchial
tree (pseudomonas bacteria).
