Palpation
Purpose: Palpation of the lower leg assists the therapist in beginning to diagnose the problem that is happening with the patient. Some conditions produce specific pain patterns or differences to palpation that should be noted. These pain patterns or differences in palpation from normal may help the therapist in the diagnostic process. For the purposes of this help page, palpation changes caused by the conditions covered in the mobile application will be detailed in the abnormal result section.
Procedure: The physical therapist should ask the patient to remove clothing from the area to be inspected. The physical therapist should touch the area using light and deep pressure to observe the involved segment or tissues and document any pain provocation that is produced or palpable changes in that are observed and document what they are.
Normal Result: Skin has normal turgor and temperature. No pitting is found with sustained pressure. Pulses easily palpated in extremity. No pain provoked with palpation.
Abnormal Result:
Arterial Insufficiency: Pulses may not be palpable. Patient's musculature may be minimally tender to palpation. Patient may report decreased sensation during palpation.
Venous Insufficiency: Usually not painful with palpation. Pitting edema present.
Compartment Syndrome: Exquisitely tender to palpation. Palpation of the extremity feels tense/tight.
Congestive Heart Failure: Non tender to palpation. Patient will report increased edema in both lower extremities. Edema may be pitting.
Deep Vein Thrombosis: Pain upon palpation of the involved side, noted to be tender. Leg on the involved side has increased warmth. A raised, red, tender cord may be palpable along the course of the involved vein. Leg may feel hard to the touch.
Lymphedema: palpation initially produces pitting, however, as lymphedema progresses, the edema becomes more "brawny" and does not pit with pressure. No discomfort with palpation. Stemmer's sign usually positive.
Musculoskeletal: pain upon palpation of muscle, tendon, ligament, or bone, in alignment with anatomical structure.
References:
Biel, A. (2014). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Books of Discovery.
Goodman, C. C., & Snyder, T. K. (2013). Differential diagnosis for physical therapists. Elsevier Health Sciences.
Procedure: The physical therapist should ask the patient to remove clothing from the area to be inspected. The physical therapist should touch the area using light and deep pressure to observe the involved segment or tissues and document any pain provocation that is produced or palpable changes in that are observed and document what they are.
Normal Result: Skin has normal turgor and temperature. No pitting is found with sustained pressure. Pulses easily palpated in extremity. No pain provoked with palpation.
Abnormal Result:
Arterial Insufficiency: Pulses may not be palpable. Patient's musculature may be minimally tender to palpation. Patient may report decreased sensation during palpation.
Venous Insufficiency: Usually not painful with palpation. Pitting edema present.
Compartment Syndrome: Exquisitely tender to palpation. Palpation of the extremity feels tense/tight.
Congestive Heart Failure: Non tender to palpation. Patient will report increased edema in both lower extremities. Edema may be pitting.
Deep Vein Thrombosis: Pain upon palpation of the involved side, noted to be tender. Leg on the involved side has increased warmth. A raised, red, tender cord may be palpable along the course of the involved vein. Leg may feel hard to the touch.
Lymphedema: palpation initially produces pitting, however, as lymphedema progresses, the edema becomes more "brawny" and does not pit with pressure. No discomfort with palpation. Stemmer's sign usually positive.
Musculoskeletal: pain upon palpation of muscle, tendon, ligament, or bone, in alignment with anatomical structure.
References:
Biel, A. (2014). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Books of Discovery.
Goodman, C. C., & Snyder, T. K. (2013). Differential diagnosis for physical therapists. Elsevier Health Sciences.
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HOAC-II-1 Trainer Help
These pages are to assist you with information you may need to work with the HOAC-II-1 Trainer Application. |