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  #1  
Old 03-06-2013
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Hammer and Otoscope Tenderness on Superficial Exam

hi ..
I have a question if there is a tenderness on superficial abd exam and the other findings depend on deeper palpation and rebound , Rovsing ,,, what to do ? not repeat this painful palpation? or tell the patient is it ok if i continue and i'll make sure i'll give u an analgesic to ease ur pain when im done with the physical exam?
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Old 03-09-2013
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Default Do NOT repeat painful maneuver

If it was a real life scenario, say in the ER or clinic setting, it would be OK to palpate for any tenderness (both superficially and deeply) in order to help you narrow down your ddx. However, for the sake of the CS exam, ask the patient where they are experiencing pain and start your examination away from there.

That's why it's also important to pay attention to the patient's nonverbal expressions, such as holding your hands to stop you from touching that area or by looking at their facial expression. Once you start palpating around the tender region and your patient experiences any discomfort (could be verbal or nonverbal), assure them that you are not going to touch that area again. Make them feel comfortable.

In summary, do NOT repeat painful maneuvers on the CS exam.

Good luck!
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Old 03-09-2013
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Default CSE videos

Quote:
Originally Posted by usmle1111 View Post
hi ..i have a question if there is a tenderness on superficial abd exam and the other findings depend on deeper palpation and reboung , rovsing ,,, what to do ? not repeat this painful palpation? or tell the patient is it ok if i continue and i'll make sure i'll give u an analgesic to ease ur pain when im done with the physical exam??????????
On one of CSE videos, painful maneuver was repeated in case to show rebound, the rest, no repeat
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Old 03-09-2013
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Default

Quote:
Originally Posted by marina99 View Post
On one of CSE videos, painful maneuver was repeated in case to show rebound, the rest, no repeat
i read kaplan cs videos,

they say deep palpation is lost art.
do rebound only when there is tenderness on palpation.

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Old 03-10-2013
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Default

thank you guys
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Old 03-13-2013
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Default

How about tenderness on palpation in a joint case? do you still try to do active/passive ROM? Like on CSE videos a case of shoulder pain she does only on the shoulder not affected by the pain...
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