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IPPA is a physical examination with four key steps: inspection, palpation, percussion, and auscultation.[1]

Although the steps are consistent across organ systems, the order may vary. Notably, for the abdominal exam, auscultation is performed before palpation,[2] because the act of palpation could change what was auscultated.


  1. Kirby RL (March 1981). "Inspection-palpation-percussion-auscultation and an outcome-oriented alternative approach to the musculoskeletal examination". Med Educ. 15 (2): 106–9. PMID 7207269.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  2. Mark Kauffman; Michele M. Roth-Kauffman (6 July 2006). History and physical examination workbook: a common sense approach. Jones & Bartlett Learning. pp. 94–. ISBN 978-0-7637-4340-6. Retrieved 6 March 2011.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>