Light palpation is used to detect tenderness and areas of muscular spasm or rigidity. The examiner should systematically palpate the entire abdomen by using the flat part of his or her right hand or the pads of the fingers, not the fingertips. The fingers should be together, and sudden jabs are to be avoided. The hand should be lifted from area to area instead of sliding over the abdominal wall. Light palpation is demonstrated in Figure 17-20.
With patients who are ticklish, it may be useful to sandwich their hand between the examiner's hands, as demonstrated in Figure 17-21.
During expiration, the rectus muscles usually relax and soften. If there is little change, rigidity is said to be present. Rigidity is involuntary spasm of the abdominal muscles and is indicative of peritoneal irritation. Rigidity may be diffuse, as in diffuse peritonitis, or localized, as over an inflamed appendix or gallbladder. In patients with generalized peritonitis, the abdomen is described as "boardlike.''
In patients who complain of abdominal pain, palpation should be performed gently. Lightly stroking the abdomen with a pin may reveal an area of increased sensation that is caused by
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