Role of Palpation in Medicine

The Importance of Palpation as Part of a Physical Exam

Breast cancer exam
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To palpate means to do a medical exam using the fingers and palms in order to check for any signs of disease. Palpation refers to the exam done by touch, as in "palpating the abdomen."

Palpation in Medicine and Health

You're likely familiar with breast palpation, but palpating other regions of the body is a very important part of a physical exam performed by a physician, or for keeping an eye on your own physical health. For those who are interested primarily in learning about breast palpation, we'll start there. Or you can skip below to learn about the role palpation plays in medicine and the other ways in which this skill is used.

Breast Palpation

There has been some controversy about doing breast exams in recent years, yet if you talk to friends and loved ones there's a good chance you'll hear about someone who found their breast cancer early because they, or their physician, did a breast exam. There are times when self-exams are very important. In general, women without risk factors for breast cancer have their first mammogram between the ages of 35 and 40. Yet we know that breast cancer can and does occur before that age. This is only one of 5 reasons why young women should perform self-breast exams.

Of course, for breast exams to give the information we are hoping for, they need to be done properly. Studies tell us that in self-exams, or even clinical breast exams, we aren't palpating the breast in a way that can adequately search for any abnormalities. Make sure you check out this illustrated guide on how to do a careful self-breast exam.

As can be seen in this illustrated guide, a picture is worth a thousand words, but sometimes a video is worth 10,000. Here you can watch a doctor describe the self-exam circle method and the wedge method of self-exam, or even how to do your own visual inspection of your breasts.

As a last note about breast palpation, we tend to forget that men can get breast cancer too. In fact, breast cancer in men tends to be found late and spread early. Learn how to do a male breast exam.

Components of a Complete Physical Exam

Medical students are reminded repeatedly that most diagnoses are made based on a thorough history and physical alone (in other words, before any labs are done or any x-rays or other studies are performed.) There are 4 critical components of a physical exam. These aren't always done on every body part but include:

  • Inspection: visually looking at the body.
  • Palpation: touching regions of the body.
  • Percussion: tapping on a region of the body listening to sound quality.
  • Auscultation: listening with a stethoscope for heart sounds or bowel sounds.

Importance of Palpation

Of all of the techniques physicians use, palpation is one of the most important. In addition, many people see a physician after they first note an irregularity or lump on their body themselves.

What Parts of the Body are Palpated on a Physical Exam?

Every examination will be different, but in a comprehensive physical, doctors palpate:

  • The arms and legs: doctors pay extra attention to any abnormalities.
  • The chest and thorax: this included a breast examination for both men and women.
  • The spine: abnormalities such as scoliosis may be detected by palpation of the spine.
  • The abdomen: palpation may detect masses but also can be used to check for an enlarged spleen or an enlarged liver.

Abnormalities on Palpation

Certainly, imaging studies can help explore abnormal findings on an examination, but palpation is often the avenue by which a need for any of these other studies is first determined.

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Article Sources
  • Metkus, T. The Physical Examination and the Fifth Maneuver. Journal of the American College of Cardiology. 2015. 66(18):2048051.
  • Verghese, A., Charlton, A., Kassierer, J., Ramsey, M., and J. Ioannidis. Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes. The American Journal of Medicine. 2015. 128(12):1322-1324.