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Respiratory Exam
 
 

Chest Percussion

 
 
 
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Overview

Chest percussion is used to assess the resonance of the lungs as a surrogate for the amount of air in the alveoli.
  • How to Perform

  • Place your left middle finger over the patient's chest, and strike the distal interphalangeal joint with your right middle finger. Tap 2-3 times, rotating the right wrist and allowing it to fall with consistent force.
Percuss the intercostal spaces from the bases to the apices, alternating from left to right and comparing the two sides.
Note whether the sound is resonant, hyperresonant or dull. Keep in mind that dullness will be present over the liver (right side) and heart (left side).
  • Interpretation

  • Resonance - vibration of the lung parenchymaNormal percussion note
  • Hyperresonance - increased thoracic gas
  • Dullness - fluid or soft tissue within pleura or lung parenchyma

Hyperresonant Percussion Note

A hyperresonant chest percussion note suggests pulmonary hyperexpansion.
  • Causes of Hyperresonant Percussion Note

  • Asthma
  • Severe emphysema
  • Pneumothorax

Dull Percussion Note

Dullness to percussion of the chest suggests reduced air in the chest due to fluid or soft tissue
  • Causes of Dull Percussion Note

  • Pleural effusion
  • Pneumonia
  • Pulmonary oedema
  • Lung cancer
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