Lung and pleura palpation

Pulmonary and pleural palpation is one of the most important tests for chest examinations. It includes examinations of respiratory movements, tactile tremors, and pleural friction. The doctor touches the midline and the lower part of the affected side with the hand, and feels the feeling of rubbing like leather when palpating, thereby determining the symptoms. Before the examination, patients were contraindicated for poor rest, improper diet, and excessive fatigue. Basic Information Specialist Category: Respiratory Examination Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to rest and diet to prevent excessive fatigue. Normal value The chest motions on both sides are the same, the same parts on both sides have the same tremor, and the feeling of rubbing like leather is not felt. Clinical significance Abnormal results: 1, one side of the chest movement limited is seen in one side of pleural effusion, pneumothorax, pleural thickening and atelectasis. 2. Both sides of the thoracic dilatation are weakened in the elderly and emphysema patients. 3. The tactile tremor is enhanced. 1 lung tissue inflammatory changes such as pneumonia, pulmonary infarction, severe tuberculosis. Due to the high density of solid tissue, sound conduction is good. 2 oppressive atelectasis (such as pulmonary atelectasis caused by pleural effusion) due to bronchial patency, so the tremor is enhanced. 3 When there is a large cavity in the lung tissue near the chest wall, the sound waves vibrate in the cavity, and the tissue around the cavity has an inflammatory infiltration, which is conducive to the transmission of sound waves. Common in tuberculosis, lung abscess and other diseases. 4. The tactile tremor weakens or disappears. 1 pleural hypertrophy, a large number of pneumothorax and pleural effusion. 2 Alveolar gas contains too much gas, such as emphysema. 3 bronchial obstruction, such as obstructive atelectasis. 4 chest wall subcutaneous emphysema. 5, tuberculous pleurisy, pneumonia, pulmonary infarction, uremia and so on. People who need to be examined: people with signs of chest and lungs. Precautions Taboo before the examination: poor rest, improper diet, excessive fatigue. Requirements for inspection: Actively cooperate with the doctor's work. Inspection process (1) Respiratory exercise, ie thoracic expansion: The doctor placed the two fingers and five fingers on the symmetrical parts of the thoracic sides. The two hands were placed under the two clavicles near the sternum. The palm and the rest of the fingers were placed on the anterior chest wall. The patients were given deep breathing exercises and the thoracic motions were compared. Is it consistent? (2) Tactile tremor: The lateral edges of the palms or the palms of the palms are placed flat on the symmetrical part of the chest wall of the patient, and the patient is repeatedly stretched with the same intensity to pronounce the "yi" sound. From top to bottom, the same part of the tremor is the same from the inside to the outside. . (3) pleural friction: The doctor touches the midline and the lower part of the affected side with the hand, and feels the feeling of rubbing like leather when palpating, thereby determining the symptoms. Not suitable for the crowd Inappropriate crowd: None. Adverse reactions and risks Nothing.