Anal diseases are very common and it is important for a medical practitioner to understand how to deal with these diseases. To establish diagnoses of specific conditions, detailed history taking, inspection, palpation including digital rectal examination, and anoscopic examination are performed. Sigmoidoscopy is also required if upper lesions are suspected. History taking should include information about bleeding, prolapse, swelling, pain, discharge, irritation, bowel habit, continence, abdominal symptoms, weight loss. Sims' position and lithotomy position are commonly used for physical examination of the anal area. In addition to careful inspection and palpation, digital rectal examination should be performed to evaluate the anal canal width and sphincter strength. Above all, digital examination is a very useful and cheap tool to find rectal cancer which commonly occurs after middle-ages. Common anal diseases such as hemorrhoids, anal fissure, perianal abscess and fistula-in-ano, pruritus anai, and rectal prolapse are reviewed.
Abscess ; Anal Canal ; Diagnosis* ; Digital Rectal Examination ; Fissure in Ano ; Hemorrhage ; Hemorrhoids ; Palpation ; Physical Examination ; Prolapse ; Pruritus ; Rectal Neoplasms ; Rectal Prolapse ; Sigmoidoscopy ; Weight Loss

OBJECTIVE: To compare the clinical usefulness of the posterior superior iliac spine (PSIS) with that of iliac crest (IC) for identifying the lumbar vertebral level. METHOD: Lumbar spine level was identified by the line connecting bilateral upper margin of iliac crests in the antero-posterior lumbar X-rays of 120 patients. Assumed IC level and assumed PSIS level were compared by 3 examiners' palpation in 60 patients. A marker was taped on assumed IC level and assumed PSIS level by 4 examiners and the postero-anterior lumbar X-rays was taken in randomly distributed 50 patients. RESULTS: IC intersection line was ranged from the L4 spinous process to the L5-S1 interspinous process in all patients. Inter- examiner agreement of palpation was significantly greater in PSIS than IC level (p<0.05). The marker indicating assumed IC level was higher than true IC level in all patients and was higher than L3-4 interspinous process in 8%. CONCLUSION: We may use PSIS level for assumption of the lumbar vertebral level to compensate for the limitation of iliac crest palpation, but at the same time keep in the mind the variarity of the PSIS level.
Humans ; Palpation* ; Spine*

OBJECTIVE: The aim of this study is to evaluate the surface anatomical landmark for the cervical epidural block by investigating the proportion of patient's prominence in the 7th cervical vertebra. And the most optimal insertion angle over the mid point between the 6th and the 7th cervical spinous process is also measured. METHOD: Patients who did a plane x-ray examination of cervical spine were selected. We performed plane x-ray after marking on cervical vertebra prominence that was assumed as the spinous process of the 7th cervical vertebra by inspection and palpation. We identified where the marker were located on the spinous process. Moreover, we measured optimal insertion angle in the plane x-ray of cervical spine lateral. RESULTS: A total 100 cases were identified. The vertebra prominence was on the 7th cervical vertebra in 62 cases and the 6th cervical vertebra in 29 cases. The 1st thoracic vertebra was in the 2 cases and the 6th and 7th cervical vertebra in the 7 cases. CONCLUSION: The vertebra prominence was identified as the spinous process of the 7th cervical vertebra in sixty two percent of the cases. And the most optimal insertion angle is a -25.28 degree angle from the perpendicular line of the skin.
Humans ; Palpation ; Skin ; Spine

34 cases of the scrotal injuries were evaluated from Jan. 1, 1980 to Jun. 30, 1984 in National Police Hospital on the testicular salvage rate in relation with the status of preoperative palpation of testis and early or delayed exploration. The rate of orchiectomy was 0 % (0/ 16) in group A(palpable testis in preoperative physical examination) and 55.5% (10/ 18) in group B(impalpable testis). In group B, the testicular salvage rate was 80% with early exploration and 0 %(0/8) with delayed explorations.
Humans ; Orchiectomy ; Palpation ; Police ; Testis

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.
Female ; Humans ; Male ; Neck ; Palpation*

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.
Female ; Humans ; Male ; Neck ; Palpation*

In Japanese Kampo, we use abdominal palpation as a clinical examination method. Abdominal palpation, a kind of tactile inspection method, which in turn is one of the four mainstays inspection methods (palpation, visual, auditory, and verbal), is the most effective technique giving one information to determine a patient's sho diagnosis. Moreover, abdominal palpation is the only clinical examination method of those traditional techniques passed down to the countries and regions of East Asia, which was developed solely in Japan. Abdominal palpation as it is practiced today stems mainly from the Koho-ha Old School of thought, which traces back to ancient Shokanron (Treatise of Cold Damage Disorders) text medicine, although it also influences the Secchu-ha Compromise School of thought. And although an awareness of abdominal palpation is perfunctory, it does require a certain amount of training and proficiency, as it is a skill. In this paper, we discuss abdominal palpation findings amassed over many long years since ancient times.
Palpation ; Abdominal ; seconds ; Clinical ; Schools

The development of subcutaneous emphysema is a well-known complication that has been reported after dental extraction, endodontic treatment, or restorative preparation. Gaseous invasion, leading to swelling, crepitus on palpation, is commonly restricted to the connective tisssues immediately adjacent to the entry site. However, the use of compressed air- and water-cooled turbines may allow large amounts of air and water to be driven through the fascial planes into the mediastinum, pleural space, or even the retroperitoneum. This case report is about the patient who presented with subcutaneous emphysema that occurred after fracture line inspection. Possible cause, treatment, and prevention of emphysema will be discussed.
Emphysema ; Humans ; Mediastinum ; Palpation ; Subcutaneous Emphysema ; Water

The authors outline the method of orchiopexy and report the results of orchiopexy performed on 79 cases (113 testes) of cryptorchism. A. Method of orchiopexy 1) In inguinal oblique skin incision, while noting frequent keloid formation, no keloid formation was noted as the lower abdominal transverse incision. 2) It was easy to descend testes to the base of the scrotal sac by performing orchidofuniculolysis sufficiently. 3) Of the several methods of orchiopexy, dartos pouch method was most ideal. B. Operative results on the 79 cases (113 testes) of cryptorchism are as follows. 1) Of the 113 testes, there were noted sufficient descent to the scrotal base in 108 testes, and somewhat insufficient descent in 5 testes. 2) In the consideration that 5 case of unsufficient descent in the group of type IV which was not detectable on manual palpation, sufficient orchidofuniculolysis should be carried out preoperatively regarding difficulties in sufficient descent. C. While operation time of cryptorchism being 4-5 years old as a rule, 25% or so are performed at 1-5 years old in authors' cases. So more active instruction should be considered.
Cryptorchidism ; Keloid ; Male ; Orchiopexy* ; Palpation ; Skin ; Testis

The palmaris longus (PL) is a slender, spindle-shaped weak flexor of the wrist. Congenital absence of the PL is estimated to occur in 15% among individuals worldwide. However, the frequency of its absence varies considerably among different population groups and with different detection techniques. In the present study, the presence of the PL tendon was examined in a Korean population (n=269) using three clinical tests, namely the Traditional Test, Mishra's Test II, and the Gangata Test. We classified subjects into six types based on whether inspection or palpation was required to determine the presence of the PL and flexor carpi radialis. The most reliable test was determined using Kendall's coefficient of concordance. Our results showed that the PL tendon was absent in 4.1% of the subjects in our study, and bilateral and unilateral absences were 2.2% and 1.8%, respectively. Statistical analysis revealed that these tests had similar reliability for assessing the PL tendon, and the Traditional Test showed the highest effectiveness, at 93%. Therefore the Traditional Test was found to be the most effective for revealing the PL in this Korean population.
Humans ; Palpation ; Population Groups ; Tendons ; Wrist