{"id":353,"date":"2021-08-28T02:29:16","date_gmt":"2021-08-28T06:29:16","guid":{"rendered":"https:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/?post_type=chapter&#038;p=353"},"modified":"2022-06-16T11:57:46","modified_gmt":"2022-06-16T15:57:46","slug":"anterior-thorax-palpation","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/chapter\/anterior-thorax-palpation\/","title":{"raw":"Anterior Thorax - Palpation","rendered":"Anterior Thorax &#8211; Palpation"},"content":{"raw":"<p style=\"text-align: left\"><span style=\"color: #000000\">Palpation of the anterior thorax involves the following steps (see <strong>Video 3.10<\/strong>):<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">1. \u00a0Begin by using the dorsa of your hands to compare <strong>temperature<\/strong> bilaterally from the apex to the bases.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">2. \u00a0While comparing bilaterally, use the finger pads of your dominant hand to palpate the anterior thorax from the apices to the base for <strong>pain, moisture, deformities, masses, or crepitus<\/strong>. Avoid palpating over breast tissue. You may need to ask the client to reposition their breasts so that you can palpate the thorax.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">While doing so:<\/span><\/p>\r\n\r\n<ul style=\"text-align: left\">\r\n \t<li><span style=\"color: #000000\">Ask the client if they have any pain.<\/span><\/li>\r\n \t<li><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note any moisture or the location, size, and description of any deformities, masses, and swelling.<\/span><\/li>\r\n \t<li><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note the location and extent of any crepitus.<\/span><\/li>\r\n<\/ul>\r\n[embed]https:\/\/youtu.be\/ZZnxrwNKVgI[\/embed]\r\n\r\n<strong>Video 3.10<\/strong>: Palpation of anterior thorax\r\n\r\n&nbsp;\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">3. \u00a0Next, assess for <strong>tactile vocal fremitus<\/strong> (see <strong>Video 3.11<\/strong>).<\/span><\/p>\r\n\r\n<ul>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Place the ulnar surface of your hands or the base of the palmar aspect of your fingers on about three to five locations on the anterior thorax on each side (see Figure 3.17). Begin at the apex and move down to the base of the lungs.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Ask the client to say \u201cfoodie\u201d or \u201ccoin\u201d each time you place your hands on the thorax.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note the equality of fremitus in comparison from the left to the right side. Remember that the vibrations will be more difficult to feel as you get closer to the bases because you are further away from the larynx.<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: center\"><img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/9.-Anterior-palpation-777x1024.jpg\" alt=\"A person's anterior chest naked with blue dots to mark the pattern of palpation.\" width=\"353\" height=\"477\" class=\"alignnone wp-image-588\" \/><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong style=\"text-align: initial;font-size: 1em\">Figure 3.18:<\/strong> Pattern for palpation of tactile vocal fremitus on anterior thorax<\/span><\/p>\r\n<span style=\"color: #000000\">Photo by<\/span> <a href=\"https:\/\/www.pexels.com\/@cottonbro\">Cottonbro<\/a> <span style=\"color: #000000\">from<\/span> <a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span>\r\n\r\n&nbsp;\r\n\r\n[embed]https:\/\/youtu.be\/ajyeLuH3dzY[\/embed]\r\n\r\n<strong>Video 3.11<\/strong>: Palpation for tactile vocal fremitus of anterior thorax\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">4. \u00a0Note the <strong>findings<\/strong><\/span><\/p>\r\n\r\n<ul>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cUpon palpation of anterior chest wall, client reports no pain, temperature warm to touch, equal bilaterally, no moisture, swelling, masses or deformities, equal tactile fremitus.\u201d<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Abnormal findings might be documented as: \u201cUpon palpation of anterior chest wall, crepitus felt in neck and upper lobe area, perspiration noted.\u201d<\/span><\/li>\r\n<\/ul>\r\n&nbsp;","rendered":"<p style=\"text-align: left\"><span style=\"color: #000000\">Palpation of the anterior thorax involves the following steps (see <strong>Video 3.10<\/strong>):<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">1. \u00a0Begin by using the dorsa of your hands to compare <strong>temperature<\/strong> bilaterally from the apex to the bases.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">2. \u00a0While comparing bilaterally, use the finger pads of your dominant hand to palpate the anterior thorax from the apices to the base for <strong>pain, moisture, deformities, masses, or crepitus<\/strong>. Avoid palpating over breast tissue. You may need to ask the client to reposition their breasts so that you can palpate the thorax.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">While doing so:<\/span><\/p>\n<ul style=\"text-align: left\">\n<li><span style=\"color: #000000\">Ask the client if they have any pain.<\/span><\/li>\n<li><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note any moisture or the location, size, and description of any deformities, masses, and swelling.<\/span><\/li>\n<li><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note the location and extent of any crepitus.<\/span><\/li>\n<\/ul>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Palpation of Anterior Thorax\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ZZnxrwNKVgI?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>Video 3.10<\/strong>: Palpation of anterior thorax<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">3. \u00a0Next, assess for <strong>tactile vocal fremitus<\/strong> (see <strong>Video 3.11<\/strong>).<\/span><\/p>\n<ul>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Place the ulnar surface of your hands or the base of the palmar aspect of your fingers on about three to five locations on the anterior thorax on each side (see Figure 3.17). Begin at the apex and move down to the base of the lungs.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Ask the client to say \u201cfoodie\u201d or \u201ccoin\u201d each time you place your hands on the thorax.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Note the equality of fremitus in comparison from the left to the right side. Remember that the vibrations will be more difficult to feel as you get closer to the bases because you are further away from the larynx.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: center\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/9.-Anterior-palpation-777x1024.jpg\" alt=\"A person's anterior chest naked with blue dots to mark the pattern of palpation.\" width=\"353\" height=\"477\" class=\"alignnone wp-image-588\" \/><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong style=\"text-align: initial;font-size: 1em\">Figure 3.18:<\/strong> Pattern for palpation of tactile vocal fremitus on anterior thorax<\/span><\/p>\n<p><span style=\"color: #000000\">Photo by<\/span> <a href=\"https:\/\/www.pexels.com\/@cottonbro\">Cottonbro<\/a> <span style=\"color: #000000\">from<\/span> <a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"Tactile Vocal Fremitus of Anterior Thorax\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ajyeLuH3dzY?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>Video 3.11<\/strong>: Palpation for tactile vocal fremitus of anterior thorax<\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">4. \u00a0Note the <strong>findings<\/strong><\/span><\/p>\n<ul>\n<li style=\"text-align: left\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cUpon palpation of anterior chest wall, client reports no pain, temperature warm to touch, equal bilaterally, no moisture, swelling, masses or deformities, equal tactile fremitus.\u201d<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"text-align: initial;font-size: 1em;color: #000000\">Abnormal findings might be documented as: \u201cUpon palpation of anterior chest wall, crepitus felt in neck and upper lobe area, perspiration noted.\u201d<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"author":177,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-353","chapter","type-chapter","status-publish","hentry"],"part":25,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapters\/353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/wp\/v2\/users\/177"}],"version-history":[{"count":19,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapters\/353\/revisions"}],"predecessor-version":[{"id":2096,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapters\/353\/revisions\/2096"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/parts\/25"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapters\/353\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/wp\/v2\/media?parent=353"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/pressbooks\/v2\/chapter-type?post=353"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/wp\/v2\/contributor?post=353"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursing\/wp-json\/wp\/v2\/license?post=353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}