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Gamora
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Not to be confused with Gamera, Gomora (disambiguation), or Gomorrah (disambiguation).
Gamora
Textless variant cover of Gamora #1 (December 2016).
Art by Marco Checchetto.
Publication information
Publisher
Marvel Comics
First appearance
Strange Tales #180 (June 1975)
Created by
Jim Starlin
In-story information
Alter ego
Gamora Zen Whoberi Ben Titan
Species
Zen-Whoberis
Team affiliations
Guardians of the Galaxy
Infinity Watch
Phalanx
United Front
Notable aliases
The Most Dangerous Woman in the Universe, Bambi Long
Abilities
Superhuman strength, speed, agility, and durability
Skilled assassin
Skilled hand-to-hand combatant
Gamora Zen Whoberi Ben Titan (/ɡəˈmɔːrə/) is a fictional character appearing in American comic books published by Marvel Comics. Created by Jim Starlin, the character first appeared in Strange Tales #180 (June 1975). Gamora is the adopted daughter of Thanos, and the last of her species. Her powers include superhuman strength and agility and an accelerated healing factor. She also is an elite combatant, being able to beat most of the opponents in the galaxy. She is a member of the group known as the Infinity Watch. The character played a role in the 2007 crossover comic book event "Annihilation: Conquest", and became a member of the titular team in its spin-off comic, Guardians of the Galaxy.
Gamora has been featured in a variety of associated Marvel merchandise. Zoe Saldana plays the character in the Marvel Cinematic Universe, starting with the 2014 film Guardians of the Galaxy. She reprised her role in the sequel Guardians of the Galaxy Vol. 2 and Avengers: Infinity War, and will appear in the Untitled Avengers film.
Contents
[hide]
1 Publication history
2 Fictional character biography
2.1 Infinity Watch
2.2 Annihilation
3 Powers and abilities
4 In other media
4.1 Television
4.2 Film
4.3 Video games
4.4 Toys
5 References
6 External links
Publication history[edit]
The character debuted in Strange Tales #180 (1975), and was created by Jim Starlin. She returned in issue #181, Warlock vol. 1 #9, 10, 11 and 15 (1975-1976), and in the 1977 annuals for Avengers and Marvel Two-in-One. In 1990, she returned in Silver Surfer vol. 3 #46-47. She had a minor role in Infinity Gauntlet #1-6 (1991) and co-starred in Warlock and the Infinity Watch #1-42 (1992-1995). She was also featured in the Infinity War (1992) and Infinity Crusade (1993) crossovers. After appearing in Infinity Abyss #1-6 (2002), Annihilation: Ronan #1-4 (2006), Annihilation #1-6 (2006) and Nova vol. 4 #4-12 (2007-2008), Gamora costarred in Guardians of the Galaxy vol. 2 #1-25 (2008-2010). She played a minor role in The Thanos Imperative #1-6 (2010).
The character, along with the other Guardians, appears in Avengers Assemble issues #4-8 (2012). She stars in Guardians of the Galaxy vol. 3, a part of the Marvel NOW! relaunch,[1] and in Guardians of the Galaxy vol. 4.[citation needed]
Fictional character biography[edit]
Gamora is the last of her species, the Zen-Whoberis, who were exterminated by the Badoon (in her original timeline, her species was exterminated by the Universal Church of Truth). Thanos found her as a child and decided to use her as a weapon. Gamora was raised and trained by Thanos to assassinate the Magus, an evil alternate version of Adam Warlock. Thanos showed her little kindness during her childhood, but Gamora was very loyal to the man who promised her the opportunity to avenge the death of her family. Gamora became very proficient in martial arts, earning the nickname "The deadliest woman in the whole galaxy". When she was a teenager, Thanos took her on a trip to Tartoonla #7. Gamora disobeyed Thanos's orders, and due to this, came into conflict with a group of thugs. She was greatly outnumbered, and despite her skills, she was defeated and then raped by the assailants. Thanos found her half dead, and in turn, murdered all of her assailants and restored her to health, cybernetically enhancing her to superhuman levels.
As an adult, Gamora was sent as an assassin against the Universal Church of the Truth, quickly becoming feared by its agents, the Black Knights. She exacted revenge for the genocide of her race by killing every member of the church involved before the event actually occurred. Gamora met and teamed up with Adam Warlock, who wanted to stop his older version.[2][3] She even managed to get close to the Magus but failed her assassination in the last second. Together with Warlock, Pip the Troll and Thanos, Gamora fought to escape the Black Knights of the Universal Church of Truth and Magus's Death Squad.[4][5][6] She was then assigned by Thanos to protect Adam Warlock, but she became suspicious of Thanos's plans, and was then attacked by Drax the Destroyer.[7]
Eventually the Magus was defeated, but Thanos revealed himself as an even-greater threat. Gamora aided Captain Mar-Vell, Drax, and the Avengers against Thanos. Gamora and Pip tried to prevent Thanos from destroying all life in the universe. Gamora attempted to slay Thanos, but he mortally wounded her, and destroyed Pip's mind.[8] Adam Warlock found them, and Gamora warned Adam of Thanos's plans, and Adam absorbed their souls into his Soul Gem. When Adam Warlock died as well, his spirit was reunited with that of his friends in "Soulworld" within the Soul Gem.[9]
Infinity Watch[edit]
Main article: Infinity Watch
Gamora (upper right) on the cover of Warlock and the Infinity Watch #8 (September 1992), with Thanos and Moondragon. Art by Tom Raney and Terry Austin.
Inside the Soul Gem was Soulworld, a place where Gamora, Pip and eventually Adam Warlock himself lived at peace. Other beings who had been absorbed by the Soul Gem, such as Kray-Tor and Autolycus, also lived in peace with former enemies.
Gamora met the Silver Surfer when he traveled to "Soulworld", and also battled Drax the Destroyer.[10][11]
When Thanos managed to obtain all the Infinity Gems, forming the Infinity Gauntlet, Adam Warlock decided that he must be stopped. Warlock led Gamora and Pip the Troll out of Soulworld into the real world. Their souls took over the bodies of three humans, who had recently died in a car crash. Gamora thus returned to the corporeal world by taking possession of the body of Bambi Long, whose body then began transforming into a duplicate of Gamora's original body. However, Gamora was soon erased from existence by Thanos when he erased half the population in the universe.[12] When Nebula claimed the Gauntlet from Thanos, Gamora returned to existence.[13]
Warlock now had the Infinity Gauntlet, giving him near omnipotence. Gamora and Pip persuaded Doctor Strange to help them find and stop Warlock, who was going mad with power.[14] The Living Tribunal intervened and Warlock divided the Infinity Gems among several guardians, known as the Infinity Watch. Gamora received the Time Gem, but was incapable of consciously using it, though it did give her sporadic precognitive dreams and visions.[15] Gamora had become romantically interested in Adam, but Adam did not respond to her. In an argument over the Infinity Watch member Maxam, Gamora left the Infinity Watch and the Time Gem behind. She returned to work as a mercenary until Adam Warlock approached her again. They continued to travel together and eventually Adam reciprocated her love. Adam and Gamora remained in a pocket dimension to raise the cosmic being known as Atleza.[16]
Annihilation[edit]
Main articles: Annihilation (comics), Annihilation: Conquest, and Guardians of the Galaxy (2008 team)
Gamora later reappears in the pages of Ronan, having left the company of Adam Warlock and settled on the world Godthab Omega as leader of a group of female warriors called The Graces, where her mind has been altered by Glorian. She is intent on re-establishing her reputation as the deadliest woman in the universe and now wields a powerful blade known as Godslayer.[17][18] At one point, she is seen reclining on a 'throne' made of corpses. She joins the United Front, using her skills to launch quick counterattacks against the Annihilation Wave. She engages in a sexual relationship with the United Front's leader, Nova.[19]
During the Phalanx's invasion of the Kree home-world following the Annihilation War, Gamora is assimilated as a "select" of the hive mind. They dispatch her to apprehend Nova after he flees the planet.[20] She's later freed by Nova and the Technarch Tyro, but left in severe distress, longing again for the sense of companionship brought by the Phalanx, and continuing to adopt her Phalanx mannerisms.[21]
She joins the new Guardians of the Galaxy.[22]
Gamora was taken prisoner by Magus when he faked the death of himself and several other Guardians.[23] She was rescued by Star-Lord[24][25] and played a minor role in the war with the "Cancerverse".[26][27]
She later appears on Earth to aid the Avengers against Thanos.[28]
During the Original Sin storyline, Gamora was seen with Moon Knight and Winter Soldier's group when they do their investigation on who murdered Uatu the Watcher.[29]
Powers and abilities[edit]
Gamora received treatments from Thanos that enhanced her speed, strength, agility, and durability to rival Adam Warlock's (to better slay the Magus, his evil, future self). Thanos also helped her become a formidable hand-to-hand combatant, trained in the martial-arts techniques from various planets, in the uses of the known weaponry of the Milky Way Galaxy, and stealth techniques. She is also a highly-skilled gymnast and assassin, and formerly possessed a telepathic link to Thanos. She uses a wide variety of weaponry, most notably a dagger whose unknown properties made it capable of slaying even beings of such immense power as Thanos and the Magus.
In the pages of Infinity Watch, it is revealed that Gamora had been cybernetically enhanced to have superhuman strength, speed, and a rapid-healing ability.[30] Gamora's strength and speed were further enhanced by Adam Warlock when they returned from Soulworld.[31]
Gamora is one of the most-skilled martial artists in the Marvel Universe. She is capable of defeating opponents who possess superhuman strength and durability that far surpass her own, and she has defeated a military platoon containing dozens of combat-trained men in only a few minutes. She has learned to paralyze or kill opponents using vital-point strikes directed at certain nerve clusters. Although skilled in the use of most conventional weapons, she prefers to use knives and swords.
While Gamora was with the Infinity Watch, she possessed the Infinity Gem called the "Time Gem". The gem was mentally linked to her, giving her the potential power to control time. She said that she did not know how to employ its powers and preferred not to use it. While she possessed the Time Gem, Gamora was prone to precognitive dreams and visions, though she had no conscious control over them.
In other media[edit]
Television[edit]
Gamora is featured in the Silver Surfer episodes "Learning Curve: Part Two", "Antibody", and "Radical Justice" voiced by Mary Long in earlier episodes,[citation needed] and later by Alison Sealy-Smith.[citation needed]
Gamora appears in the Ultimate Spider-Man cartoon series, voiced by Nika Futterman.[32] In the episode "Guardians of the Galaxy", she is seen as a member of the Guardians of the Galaxy. In the episode "The Return of the Guardians of the Galaxy", Gamora was seen recuperating on the Guardians of the Galaxy's spaceship when they land on Earth at the time when Titus leads the Chitauri into targeting Nova's helmet. When she recovers in time to help fight Titus's forces, she voiced her disdain that they had to land on Earth. After Titus was defeated and the remaining Chitauri escape, Nick Fury was displeased that Gamora showed up on Earth again when she said that she wouldn't return. Gamora stated "I lied" and then left with the Guardians of the Galaxy with Titus in their custody.
Gamora appears in Avengers Assemble, initially reprised by Nika Futterman (in "Guardians and Spaceknights"),[32] and later voiced by Laura Bailey (in "Widow's Run").[32]
Gamora appears in the Hulk and the Agents of S.M.A.S.H. episodes "It's a Wonderful Smash" and "Guardians of the Galaxy", where Nika Futterman reprises her role.[33]
Gamora appears in Marvel Disk Wars: The Avengers episodes 24 and 25, voiced by Junko Kitanishi.[citation needed]
Gamora appears as one of the leads in the 2015 Guardians of the Galaxy animated series, voiced by Vanessa Marshall.[34]
Film[edit]
Gamora makes a non-speaking cameo appearance in the animated direct-to-video film Planet Hulk.[35] She was seen as an audience member in the Sakaar arena.
Zoe Saldana as Gamora in a character poster for the 2014 film Guardians of the Galaxy.
Zoe Saldana plays Gamora in the Marvel Studios film Guardians of the Galaxy, which was released on August 1, 2014.[36][37][38] After her family was killed by Thanos when she was a child, she was tortured, adopted by Thanos and raised as an assassin, only to rebel against him when she learned of his deal with Ronan the Accuser to destroy planet Xandar in return for the Kree giving him an orb. Attempting to claim the orb to sell it to the Collector so she can get as far as she can from her adopted father, Gamora allies with the other Guardians to escape prison. But after Ronan claims the orb, revealed to contain an Infinity Stone, Gamora decides to fight alongside the Guardians to reclaim it and stop Ronan despite the odds against them, stating that, after living among enemies for years, she would be glad to die beside friends. After saving Xandar, Gamora was cleared of her previous crimes.
Zoe Saldana reprised the role in Guardians of the Galaxy Vol. 2, released in 2017.[39] While travelling with Peter's father Ego and his empathic assistant Mantis, Mantis confirmed that Quill is in love with Gamora, but Gamora declines Peter's initial efforts to discuss their feelings. However, after a confrontation with Nebula forces Gamora to face her own conflicting feelings about her relationship with her sister, followed by Peter almost dying in the battle against Ego, Gamora gives him a tentative hint that she reciprocates his feelings while seeing the strange family they have created.[40]
Saldana reprises her role in the film Avengers: Infinity War.[41] In a flashback, Ariana Greenblatt portrays her as a child.[42] In the film, when Thanos is revealed to be after the Infinity Stones, Gamora makes Peter promise to kill her due to the fact she holds life or death information, sharing a passionate kiss with him afterwards. After the Guardians return to a destroyed Knowhere in search of the Reality Stone, Gamora is kidnapped by Thanos when it's revealed she is aware of the location of the Soul Stone, but not before both Peter and Gamora declare their love for one another. Gamora at first denies knowledge on the location of the Soul Stone, but is forced to reveal its whereabouts in order to save Nebula's life. Gamora leads him to Vormir, where the Soul Stone can only be retrieved by the sacrifice of someone the potential wielder loves. Erroneously believing Thanos loves no one, she happily gloats that Thanos would never achieve his goal, only to be sacrificed by her adoptive father and is thrown to her death. Her death allows a grief-stricken Thanos to receive the Soul Stone. After being struck by Thor's Stormbreaker, Thanos has a vision of Gamora's child form.
Saldana will be reprising her role in the upcoming untitled Avengers sequel.[43]
Video games[edit]
Gamora appears in Lego Marvel Super Heroes, voiced by Danielle Nicolet.[citation needed]
Gamora is a playable character in the Facebook game Marvel: Avengers Alliance.[citation needed]
Gamora is a playable character in foxnext game Marvel Strike Force
Gamora is playable in the video game Disney Infinity: Marvel Super Heroes and Disney Infinity 3.0, voiced by Nika Futterman.[citation needed]
Gamora is a playable character in the game Marvel: Contest of Champions.[citation needed]
Gamora is a playable character in Marvel: Future Fight.[citation needed]
Gamora appears in Guardians of the Galaxy: The Telltale Series, voiced by Emily O'Brien.[44]
There are two playable versions of Gamora available to recruit in the match-three mobile game Marvel Puzzle Quest. The most recent variant, in the game's four star category, was added to the game in May 2017.[45]
Gamora will appear as a playable character in Marvel vs. Capcom: Infinite,[46] with Vanessa Marshall reprising her role.[47]
Toys[edit]
Gamora was featured in The Classic Marvel Figurine Collection in 2012.[48] Her number in the series is 189.
A Gamora figure is part of the Marvel Legends line based on the Guardians of the Galaxy movie.
A comic book version of the character was released with her teammates in a boxed set by Hasbro.
References[edit]
Jump up ^ Richards, Dave (14 October 2012). "NYCC: Bendis, McNiven & Wacker Relaunch the "Guardians of the Galaxy"". Comic Book Resources. Retrieved 15 October 2012.
Jump up ^ Jim Starlin (w), Jim Starlin (p), Jim Starlin, Alan Lee Weiss (i). "The Judgment!" Strange Tales 180 (June 1975), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Al Milgrom (i). "1000 Clowns!" Strange Tales 181 (August 1975), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Steve Leialoha (i). "The Infinity Effect" Warlock 9 (October 1975), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Steve Leialoha (i). "How Strange my Destiny! Part 1: The Rice!" Warlock 10 (December 1975), Marvel Comics
Jump up ^ Jim Starlin (w), Steve Leialoha, Jim Starlin (p), Steve Leialoha (i). "How Strange My Destiny! Part 2: Escape Into the Inner Prison!" Warlock 11 (February 1976), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p). "Just a Series of Events" Warlock 15 (November 1976), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Josef Rubinstein (i). "The Final Threat" Avengers Annual 7 (November 1977), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Josef Rubinstein (i). "Death Watch!" Marvel Two-in-One Annual 2 (December 1977), Marvel Comics
Jump up ^ Jim Starlin (w), Ron Lim (p), Tom Christopher (i). "... The Soul World" Silver Surfer v3, 46 (February 1991), Marvel Comics
Jump up ^ Jim Starlin (w), Ron Lim (p), Tom Christopher (i). "Adam Warlock Protector of the Soulworld!" Silver Surfer v3, 47 (March 1991), Marvel Comics
Jump up ^ Jim Starlin (w), George Pérez (p), Tom Christopher, Josef Rubinstein (i). "God" The Infinity Gauntlet 1 (July 1991), Marvel Comics
Jump up ^ Jim Starlin (w), Ron Lim (p), Josef Rubinstein (i). "The Final Confrontation" The Infinity Gauntlet 6 (December 1991), Marvel Comics
Jump up ^ Dann Thomas, Roy Thomas (w), Dan Lawlis (p), Andrew Pepoy (i). "Footnote to Infinity" Doctor Strange v3, 36 (December 1991), Marvel Comics
Jump up ^ Jim Starlin (w), Angel Medina (p), Terry Austin (i). "Gathering the Watch!" Warlock and the Infinity Watch 2 (March 1992), Marvel Comics
Jump up ^ Jim Starlin (w), Jim Starlin (p), Al Milgrom (i). "Rewards & Punishment" Infinity Abyss 6 (October 2002), Marvel Comics
Jump up ^ Simon Furman (w), Jorge Lucas (p). Annihilation: Ronan 3 (August 2006), Marvel Comics
Jump up ^ Simon Furman (w), Jorge Lucas (p). Annihilation: Ronan 4 (September 2006), Marvel Comics
Jump up ^ Keith Giffen (w), Andrea Di Vito (p). "Blood and Thunder" Annihilation 1 (October 2006), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Sean Chen, Brian Denham (p), Brian Denham, Scott Hanna (i). "Alone" Nova v4, 4 (September 2007), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Paul Pelletier (p), Rick Magyar (i). "Terminal: Part 1" Nova v4, 11 (May 2008), Marvel Comics
Jump up ^ Greeting the Guardians: Drax and Gamora Archived 2009-02-21 at the Wayback Machine., Newsarama, May 13, 2008
Jump up ^ Dan Abnett, Andy Lanning (w), Wes Craig (p). "Seconds Out" Guardians of the Galaxy v2, 19 (December 2009), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Wes Craig (p), Serge LaPointe (i). Guardians of the Galaxy v2, 23 (April 2010), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Wes Craig (p), Serge LaPointe (i). Guardians of the Galaxy v2, 24 (May 2010), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Miguel Sepulveda (p). "The Thanos Imperative (Part 1 of 6)" The Thanos Imperative 1 (August 2010), Marvel Comics
Jump up ^ Dan Abnett, Andy Lanning (w), Miguel Sepulveda (p). "The Thanos Imperative (Part 6 of 6)" The Thanos Imperative 6 (January 2011), Marvel Comics
Jump up ^ Brian Michael Bendis (w), Mark Bagley (p), Danny Miki (i). "At the Command of Thanos" Avengers Assemble 4 (August 2012), Marvel Comics
Jump up ^ Original Sin #1
Jump up ^ Jim Starlin (w), Angel Medina (p), Bob Almond (i). "Old Wounds" Warlock and the Infinity Watch 9 (October 1992), Marvel Comics
Jump up ^ Jim Starlin (w), Angel Medina (p), Bob Almond (i). "Strange Encounters" Warlock and the Infinity Watch 14 (March 1993), Marvel Comics
^ Jump up to: a b c "Voice Of Gamora - Spider-Man | Behind The Voice Actors". Behind The Voice Actors. Retrieved August 16, 2017. Check mark indicates role has been confirmed using screenshots of closing credits and other reliable sources
Jump up ^ "It's a Wonderful Smash". Hulk and the Agents of S.M.A.S.H. Season 1. Episode 25. July 6, 2014. Disney XD.
Jump up ^ "Guardians Of The Galaxy Animated Series Adds Star Wars Rebels' Vanessa Marshall As Gamora". Comicbook.com.
Jump up ^ Radtke, Chris (February 1, 2010). "Planet Hulk is Loaded With Random Marvel Universe Cameos". Archived from the original on September 11, 2012. Retrieved September 10, 2012.
Jump up ^ Kit, Borys (July 14, 2012). "'Comic-Con 2012: Marvel Names 'Avengers' Follow-Ups; Robert Downey Jr. Makes Surprise Appearance'". The Hollywood Reporter. Archived from the original on August 5, 2012. Retrieved July 16, 2012.
Jump up ^ Kit, Borys (April 3, 2013). "Zoe Saldana in Talks to Star in Marvel's 'Guardians of the Galaxy' (Exclusive)". The Hollywood Reporter. Archived from the original on April 3, 2013. Retrieved April 3, 2013.
Jump up ^ Kit, Borys (April 22, 2013). "'Guardians of the Galaxy' Adds One More to Cast (Exclusive)". The Hollywood Reporter. Archived from the original on April 22, 2013. Retrieved April 22, 2013.
Jump up ^ Vejvoda, Jim (July 15, 2016). "Guardians of the Galaxy Vol. 2: Zoe Saldana On Gamora, Nebula And Thanos". IGN. Archived from the original on July 17, 2016. Retrieved July 16, 2016.
Jump up ^ http://waltdisneystudiosawards.com/media/scripts/GotG2.pdf
Jump up ^ Deen, Sarah (April 24, 2017). "Has Guardians of the Galaxy Star Zoe Saldana Revealed the Name of Avengers 4?". Metro. Retrieved December 31, 2017.
Jump up ^ "Ariana Greenblatt Shares Behind-the-Scenes Photos From 'Avengers'". Just Jared Jr. April 29, 2018. Retrieved April 30, 2018.
Jump up ^ Deen, Sarah (April 24, 2017). "Has Guardians of the Galaxy Star Zoe Saldana Revealed the Name of Avengers 4?". Metro. Retrieved December 31, 2017.
Jump up ^ Yin-Poole, Wesley (10 March 2017). "Nolan North is Rocket in Telltale's Guardians of the Galaxy game".
Jump up ^ "Piecing Together Marvel Puzzle Quest: Gamora". News - Marvel.com.
Jump up ^ "New gameplay footage of Marvel vs. Capcom: Infinite, official artwork, game covers, screens and more".
Jump up ^ Capcom. Marvel vs. Capcom: Infinite. Capcom. Scene: Credits, "Cast".
Jump up ^ "Homepage". Eaglemoss.
External links[edit]
Gamora at Marvel.com
Gamora at the Comic Book DB
Burch, Jeanne; McQuaid, Sean. "Gamora". Women of Marvel Comics (WOMC). Archived from the original on November 5, 2006.
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Palpation
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Not to be confused with palpitations.
"Palpable" is not to be confused with "palpebral".
Palpation
Palpation of a child's abdomen
MeSH
D010173
MedlinePlus
002284
[edit on Wikidata]
Look up palpation in Wiktionary, the free dictionary.
Look up palpable in Wiktionary, the free dictionary.
Palpation is the process of using one's hands to examine the body, especially while perceiving/diagnosing a disease or illness.[1] Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine its size, shape, firmness, or location (for example, a veterinarian can feel the stomach of a pregnant animal to ensure good health and successful delivery).
Palpation is an important part of the physical examination; the sense of touch is just as important in this examination as the sense of sight is. Physicians develop great skill in palpating problems below the surface of the body, becoming able to detect things that untrained persons would not. Mastery of anatomy and much practice are required to achieve a high level of skill. The concept of being able to detect or notice subtle tactile signs and to recognize their significance or implications is called appreciating them (just as in general vocabulary one can speak of appreciating the importance of something). Nonetheless, some things are not palpable, which is why additional medical tests, such as medical imaging and laboratory tests, are often needed to make a diagnosis. However, many other problems are palpable. Examples include pulses, abdominal distension, cardiac thrills, fremitus, and various hernias, joint dislocations, bone fractures, and tumors, among others.
Contents
[hide]
1 Uses
2 Locating anatomical landmarks
3 Elastography
3.1 Computerized palpation
4 Palpation under general anesthesia
5 See also
6 References
Uses[edit]
Palpation is used by physicians, as well as chiropractors, massage therapists, physical therapists, osteopaths and occupational therapists, to assess the texture of a patient's tissue (such as swelling or muscle tone), to locate the spatial coordinates of particular anatomical landmarks (e.g., to assess range and quality of joint motion), and assess tenderness through tissue deformation (e.g. provoking pain with pressure or stretching). In summary, palpation might be used either to determine painful areas and to qualify pain felt by patients, or to locate three-dimensional coordinates of anatomical landmarks to quantify some aspects of the palpated subject.
Palpation is typically used for thoracic and abdominal examinations, but can also be used to diagnose edema and to measure the pulse. It is used by veterinarians to check animals for pregnancy, and by midwives to determine the position of a fetus.
Quantitative palpation of anatomical landmarks for measurements must occur according to strict protocols if one wishes to achieve reproducible measurements. Palpation protocols are usually based on well-described definitions for the location of anatomical, usually skeletal, landmarks.
Locating anatomical landmarks[edit]
Locating anatomical landmarks can be performed using two palpation protocols: 1) manual palpation that allows the spatial location of landmarks using hands combined or not with three-dimensional (3D) digitizing, and 2) virtual palpation on 3D computer models obtained, for example, from medical imaging.
Manual palpation of skeletal landmarks combined with 3D digitizing (see text below for explanations).
Virtual palpation of skeletal landmarks.
Manual palpation of skeletal landmarks (illustrated here on a patient's shoulder, see left image). The gauntlet on the palpating hand (left) allows to locate the spatial coordinates of the palpated landmarks with a satisfactory accuracy (below 1 cm). Reflective markers are part of the scientific protocol and allow further quantified motion analysis for joint disorders follow-up.
Virtual palpation of skeletal landmarks located on a 3D bone model (illustrated here on a patient's knee model obtained from medical imaging, see right image). Colored spheres on bones indicate palpated skeletal landmarks. This method combined with quantified manual palpation allows subject-specific visualization of joint behavior during particular motion tasks (e.g., walking, stair climbing, etc.).
The above protocols can be used independently. Manual palpation is used in clinical activities for various aims: - identification of painful areas; - positioning of particular pieces of equipment (electromyography electrodes, auscultation, external landmarks used in clinical motion analysis or body surface scanning); or - measurements of morphological parameters (e.g., limb length). Virtual palpation alone is useful to quantify individual morphological parameters from medical imaging: - limb length; - limb orientation; - joint angle; or - distance between various skeletal locations.
Combining data from both manual and virtual palpation protocols allows achieving supplementary analysis: - registration protocols aiming at building reference frames for motion representation according reproducible clinical conventions; - to modelize joint kinematics accurately during musculoskeletal analysis; - to align precisely orthopedic tools according to the individual anatomy of a patient; or - to wrap and to scale surface textures to motion data when creating animation characters.
Use of standardized definitions for the above activities allows better result comparison and exchange;[2] this is a key element for patient follow-up or the elaboration of quality clinical and research databases. Such definitions also allow acceptable repeat ability by individuals with different backgrounds (physiotherapists, medical doctors, nurses, engineers, etc.). If applied strictly, these definitions allow better data exchange and result comparison thanks to standardization of the procedure. Without anatomical landmark standardization, palpation is prone to error and poorly reproducible.
Elastography[edit]
Conventional ultrasonography (lower image) and elastography (supersonic shear imaging; upper image) of papillary thyroid carcinoma, a malignant cancer. The cancer (red) is much stiffer than the healthy tissue.
Main article: Elastography
Nowadays, the medical imaging modality of elastography can also be used to determine the stiffness of tissues. Manual palpation suffers from several important limitations: it is limited to tissues accessible to the physician's hand, it is distorted by any intervening tissue, and it is qualitative but not quantitative. Elastography is able to overcome many these challenges and improve on the benefits of palpation.
Elastography is a relatively new technology and entered the clinic primarily in the last decade. The most prominent techniques use ultrasound or magnetic resonance imaging (MRI) to make both the stiffness map and an anatomical image for comparison.
Computerized palpation[edit]
While not widespread amongst elastography methods, computerized palpation is of interest here because it essentially uses palpation to measure the stiffness, whereas other techniques will obtain data using other methods. Computerized palpation is also called "Tactile Imaging", "Mechanical imaging" or "Stress imaging", is a medical imaging modality that translates the sense of touch into a digital image. The tactile image is a function of P(x,y,z), where P is the pressure on soft tissue surface under applied deformation and x,y,z are coordinates where pressure P was measured. Tactile imaging closely mimics manual palpation, since the probe of the device with a pressure sensor array mounted on its face acts similar to human fingers during clinical examination, slightly deforming soft tissue by the probe and detecting resulting changes in the pressure pattern.
Palpation under general anesthesia[edit]
Palpation under general anesthesia is sometimes necessary, such as when there is a need to palpate structures deep in the abdominal or pelvic cavity, since it would otherwise cause considerable patient discomfort and subsequent contraction of the abdominal muscles which would make the examination difficult.[3] It is used, for example, in the staging of cervical cancer.
See also[edit]
Physical examination
Inspection (medicine)
Percussion (medicine)
Elastography
Auscultation
Motion analysis
Medical imaging
Tactile imaging
References[edit]
Jump up ^ http://dictionary.reference.com/browse/palpation
Jump up ^ Van Sint Jan S, Della Croce U 2005 Identifying the location of human skeletal landmarks: why standardized definitions are necessary – a proposal. Clinical Bio mechanics 20:659-660.
Jump up ^ Pelvic examination under anesthesia at Uptodate. Author: William J Mann, Jr, MD. This topic last updated: Oct 8, 2012.
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text:
Open primaries in the United States
From Wikipedia, the free encyclopedia
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An open primary is a primary election that does not require voters to be affiliated with a political party in order to vote for partisan candidates. In a traditional open primary, voters may select one party's ballot and vote for that party's nomination. As in a closed primary, the highest voted candidate in each party then proceeds to the general election. In a nonpartisan blanket primary, all candidates appear on the same ballot and the two highest voted candidates proceed to the runoff election, regardless of party affiliation. The constitutionality of this system was affirmed by the Supreme Court of the United States in 2008,[1] whereas a partisan blanket primary was previously ruled to be unconstitutional in 2000.[2] The arguments for open primaries are that voters can make independent choices, building consensus that the electoral process is not splintered or undermined by the presence of multiple political parties.
Contents
1 Voter participation
2 Manipulation and dilution
3 Constitutional issues
4 California and Primary Election Alternatives
5 States with an open presidential primary
6 States with open primaries for other elections
7 Notes and references
Voter participation[edit]
The open primary could be seen as good for voter participation. First, the open primary allows nonpartisan or independent voters to participate in the nominating process.[3] If these voters are allowed to help select the nominees then they may be more likely to vote in the general election, since one of the candidates could be someone the non-partisan voter voted for. Also, a moderate member of one party may agree more with a candidate for the nomination of another party. This voter will have more of an incentive to participate in the general election if there is a nominee whom he or she agrees with.[3]
The open primary could also be viewed as bad for voter participation. In Hawaii, primary voter turnout fell from 74.6% in 1978 to 42.2% in 2006 after changing to open primaries which could be the result of many things—not just the move towards the open primary system.[4] The closed primary system had more of an incentive for people to join one of the major parties. This led to people being more involved in the voting process. With the open primary, some argue, more voters become independent and are less likely to participate in the nominating or election processes.[3]
Manipulation and dilution[edit]
Opponents of the open primary believe that the open primary leaves the party nominations vulnerable to manipulation and dilution. First, one party could organize its voters to vote in the other party's primary and choose the candidate that they most agree with or that they think their party could most easily defeat. Secondly, in the open primary moderates and independent voters can vote in either party. This occurrence may dilute the vote of a particular party and lead to a nominee who does not represent the views of his or her particular party.
For example, in the 2008 presidential primaries, exit polls say John McCain failed to win a single race among Republican voters, up to Super Tuesday, yet during that same period he went from "also-ran" to front runner, because most non-Republicans who crossed over voted for him. In New Hampshire, Mitt Romney won among registered Republicans, but John McCain won overall [1]. Likewise, in South Carolina, Mike Huckabee won among self-identified Republicans, but John McCain won the state [2].
Similarly, some Republican advocates called for Republicans to cross over and vote in the Democratic race, to help Barack Obama win, on the premise that Clinton had a better chance of beating their candidate. The Rush Limbaugh Show's "Operation Chaos" is the best known of these movements.
Constitutional issues[edit]
Opponents of the open primary argue that the open primary is unconstitutional. These opponents believe that the open primary law violates their freedom of association, because it forces them to allow outsiders to select their candidates. An opposing view is that political parties are not mentioned in the U.S. Constitution in any language, but voting rights of the individual are clearly defined.
Freedom of association has been recognized by the United States Supreme Court. First, in NAACP v. Alabama, the court said that "It is beyond debate that freedom to engage in association for the advancement of beliefs and ideas is an inseparable aspect of the "liberty" assured by the Due Process Clause of the Fifth and Fourteenth Amendment, which embraces freedom of speech."[5]
In other words, the freedom of association is part of the freedom of speech. The freedom of speech, which is found in the First Amendment to the United States Constitution, is applied to the states through the fourteenth amendment. In Gitlow v. New York, Justice Sanford states that "[f]or present purposes we may and do assume that freedom of speech and of the press-which are protected by the First Amendment from abridgment by Congress-are among the fundamental personal rights and 'liberties' protected by the due process clause of the Fourteenth Amendment from impairment by the States."[6]
This constitutionality raises a problem. The most popular alternative to the open primary is the closed primary. However, a mandatory closed primary can also be unconstitutional. In Tashjian v. Republican Party of Connecticut, the United States Supreme Court determined that Connecticut's closed primary law was unconstitutional. The Connecticut closed primary law "[required] voters in any political party primary to be registered members of that party".[7] The Republican Party of Connecticut, however, wanted to allow independents to vote in the Republican primary if they so chose. The problem with this closed primary law was that it prevented the Republican Party from allowing independent "registered voters not affiliated with any party to vote in Republican primaries for federal and statewide offices".[7] Since the Republican Party of Connecticut was not able to choose who it wanted to vote in the primary, the United States Supreme Court, in a 5-4 decision, stated that the closed primary law in Connecticut "impermissibly burdens the right of the Party and its members protected by the First and Fourteenth Amendments".[7]
On October 1, 2007, the U.S. Court of Appeals for the Fourth Circuit ruled that the Virginia mandatory open primary statute was unconstitutional as applied to the Republicans because it imposed a burden on their freedom to associate under the First Amendment, although it explicitly did not rule on the question of whether an open primary law was in general unconstitutional as a burden on association.[8]
California and Primary Election Alternatives[edit]
A "modified closed primary" was in effect in California from 2001 to 2011.[9] Each political party could decide whether or not they wish to allow unaffiliated voters to vote in their party's primary. This appeared to avoid the constitutional concerns of both the open and the closed primary. In the 2004 and 2006 primary elections, the Republican, Democratic, and American Independent parties all opted to allow unaffiliated voters to request their party's ballot. However, since the 2008 presidential primary election, only the Democratic and American Independent parties took this option, while the Republican party did not.[10]
In 2011, the state adopted a "modified open primary". Individual citizens may vote for any candidate, and the top two candidates regardless of party will advance to the general election. The Presidential election is exempt from this voting method as it is a contest for delegates rather than a direct election for an office.
A potential side effect of the open primary is that parties that run more candidates may find themselves at a disadvantage, since their partisan supporters' votes will be split more ways in the primary and thus those candidates may have a harder time reaching the top-two ranking when competing with parties that run fewer candidates.[11]
States with an open presidential primary[edit]
Alabama
Arizona
Arkansas
Colorado
Georgia
Illinois
Indiana
Massachusetts (All races' primaries open for "unenrolled"/unaffiliated voters only)
Michigan
Mississippi
Missouri
Montana
New Hampshire
North Carolina (All races' primaries open for unaffiliated voters only)[12]
North Dakota
Ohio (semi-open) [13]
Oklahoma (Only Democratic primary is open to Independent voters as of November 2015) [14]
South Carolina
Tennessee
Texas
Vermont
Virginia
Wisconsin[15]
States with open primaries for other elections[edit]
The state of Arizona has open primaries for all elections except for presidential primaries.
A similar system known as a nonpartisan blanket primary has been used in Louisiana for state and local elections since 1976, and began to be used in Washington, after numerous court challenges, in 2008.
In California, under Proposition 14, a measure that easily passed, traditional party primaries were replaced in 2011 with wide-open elections. Proposition 14, known as the open primary measure, gave every voter the same ballot in primary elections for most state and federal races, except the presidential contest.[16][17]
Most primaries in New York are closed, but state law contains a provision allowing parties to use a different method if they want. Currently, only the Independence Party chooses to allow unaffiliated voters to participate.
Notes and references[edit]
Jump up ^ Washington State Grange v. Washington State Republican Party, 552 U.S. 442 (2008).
Jump up ^ California Democratic Party v. Jones, 530 U.S. 567 (2000).
^ Jump up to: a b c HeraldTribune.com - News - News stories about Sarasota, Manatee and Charlotte counties in Florida, from the newspapers of record. - HeraldTribune.com
Jump up ^ "Hawaii Democrats vote to keep open primary". Retrieved 2008-02-27.
Jump up ^ NAACP v. Alabama, http://caselaw.lp.findlaw.com/cgi-bin/getcase.pl?navby=volpage&court=us&vol=357&page=460#460
Jump up ^ Gitlow v. New York, http://caselaw.lp.findlaw.com/cgi-bin/getcase.pl?court=us&vol=268&invol=652
^ Jump up to: a b c Tashjian v. Republican Party of Connecticut December 10, 1986. 479 U.S. 208.
Jump up ^ Miller v. Brown
Jump up ^ Green, Matthew (6 June 2016). "Making Sense of California's Top-Two Primary System". KQED News. Retrieved 27 May 2018.
Jump up ^ California Secretary of State, "Archived copy". Archived from the original on 2012-01-18. Retrieved 2012-03-02. CS1 maint: Archived copy as title (link)
Jump up ^ Martin, Jonathan (26 May 2018). "Democrats Go All-Out to Avoid Disaster in California House Races". New York Times. Retrieved 27 May 2018.
Jump up ^ "Who can vote in which elections?". NC Voter (.org). Retrieved 2016-04-20.
Jump up ^ "Ohio's May primary attracted 'party switchers,' unaffiliated voters". Cleveland(.com). Retrieved 2018-10-05.
Jump up ^ KFOR.com - Oklahoma Independent voters now allowed to vote in Democratic Primary
Jump up ^ "Primaries: Open and Closed". FairVote. February 2008. Retrieved 2016-03-21.
Jump up ^ McKinley, Jesse (June 9, 2010). "Calif. Voting Change Could Signal Big Political Shift". The New York Times.
Jump up ^ Buchanan, Wyatt; Jones, Carolyn (August 8, 2010). "Voters approve Prop. 14, open primary measure". The San Francisco Chronicle.
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