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Old 03-14-2012
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Hammer and Otoscope Palpating painful areas; to do it or not!

Hey everybody,
After reading several threads about painful areas, I am still confused about some points:

1. If patient complains of LUQ pain, do we still palpate the area? If yes, do we palpate it again to check for splenomegaly?
2. If patient has pain on direct RUQ palpation, can we perform Murphy's? Can we percuss to check for liver span?

Goodluck to everyone!
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Old 03-14-2012
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hi, there are differing opinions on this matter, but if you follow FA you will see that often you have to perform painful manuevers inorder to be able to make a diagnosis.
so i will suggest if you have RLQ pain, you know that you should check rebound. so inadvance the px has told you where the pain is, so you say Mr A i know you have pain here, i am going to need to touch it but i will be very gentle, i need for you to tell me when it hurts the ,ost, when i press in or when i remove my hand, this way you have combined 2 examinations: direct and rebound tenderness. sir i will need to do one more test to help me arrive at a diagnosis so you do psoas or obturator, personally i will choose just one of the two not both and then sincerely apologise for causing pain but explain that these manuevers have helped you in reaching some diagnosis.

about RUQ i think you should do murphys, if theres a way of combining the palpation and murphys into one then i will do it that way.
i know i have not really answered your question, maybe someone else will come and add to this. all the best. pls practise your PN, just speaking from experience
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ajaja (03-15-2012)
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Old 03-15-2012
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Smile

Quote:
Originally Posted by nativedoc2 View Post
hi,............. just speaking from experience
thanks you!!
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