![]() ![]() Stony dull, the sounds produced on percussion from the pleximeter with no contribution from the underlying area.Dull (consolidation), similar to percussion of a mass such as a liver.Impaired resonance (mass, consolidation) lower than normal percussion sounds.Normal resonance/ Resonant, the sound produced by percussing a normal chest.Hyperresonant (pneumothorax), said to sound similar to percussion of puffed up cheeks.Tympanitic, drum-like sounds heard over air filled structures during the abdominal examination.The sound thus generated is used to determine if the tissue is healthy or pathological.īased on the auditory and tactile perception, the notes heard can be categorized as: It is based on the principle of setting tissue and spaces in between at vibration. It is used to find whether any organ is enlarged and similar (assessing for organomegaly). It can be used to assess the respiratory mobility of the thorax. It is used to diagnose pneumothorax, emphysema and other diseases. Leopold Auenbrugger is said to be the person who introduced the technique to modern medicine, although this method was used by Avicenna about 1000 years before that for medical practice such as using percussion over the stomach to show how full it is, and to distinguish between ascites and tympanites. Percussion was at first used to distinguish between empty and filled barrels of liquor, and Dr. As well as producing different notes which can be heard they also produce different sensations in the pleximeter finger. A more resonant sound indicates hollow, air-containing structures. A dull sound indicates the presence of a solid mass under the surface. Broadly classifying, there are four types of percussion sounds: resonant, hyper-resonant, stony dull or dull. There are two types of percussion: direct, which uses only one or two fingers and indirect, which uses only the middle/flexor finger. When percussing boney areas such as the clavicle, the pleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of tuberculosis. The nonstriking finger (known as the pleximeter) is placed firmly on the body over tissue. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. It is one of the four methods of clinical examination, together with inspection, palpation, auscultation, and inquiry. Percussion is a method of tapping on a surface to determine the underlying structures, and is used in clinical examinations to assess the condition of the thorax or abdomen. Over the stomach, but is not a normal chest sound.Percussion is a technique of clinical examination. Sounds are hollow, high, drumlike sounds. An area of hyperresonance on one side of the chest With air, such as may occur in patients with COPD, or patients having anĪcute asthmatic attack. ![]() Hyperresonant sounds may also be heard when percussing lungs hyperinflated Normally heard when percussing the chests of children and very thin adults. Sounds that are louder and lower pitched than resonant sounds are Replaces air-containing lung tissues, such as occurs with pneumonia, pleural Dullness replaces resonance when fluid or solid tissue Or thudlike sounds are normally heard over dense areas such as Or extremely dull sounds are normally heard over solid areas such Sounds are low pitched, hollow sounds heard over normal lung tissue. Look at the following diagram that shows percussion notes on the posterior chest: Visualize the structures underneath as you proceed. Work from the top part of the chest downward, comparing sounds heard on both the right and left sides of the chest. Then, strike the finger placed on the patient's skin with the end of the middle finger of your dominant hand. Place the first part of the middle finger of your nondominant hand firmly on the patient's skin. Percussing the anterior chest is most easily done with the patient lying supine the patient should sit when percussing the posterior chest. Percussion helps to determine whether the underlying tissues are filled with air, fluid, or solid material. Percussion sets the chest wall and underlying tissues into motion, producing audible sounds and palpable vibrations. Just as lightly tapping on a container with your hands produces various sounds, so tapping on the chest wall produces sounds based on the amount of air in the lungs. Percussion is an assessment technique which produces sounds by the examiner tapping on the patient's chest wall.
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