Overview
This lecture reviews the key findings and expected sounds produced during indirect percussion over the chest, abdomen, and related anatomical structures, emphasizing their clinical significance.
Basics of Indirect Percussion
- Indirect percussion involves tapping on a finger placed over the structure to assess underlying tissues by sound produced.
- This technique is used mostly by advanced practice nurses and providers in thorough assessments.
Percussion Sounds and Their Significance
- Resonance: Low-pitched, hollow sound heard over normal, healthy lung fields (must percuss in the intercostal space, not over ribs).
- Hyper-resonance: Low-pitched, booming sound indicating excess air (e.g., COPD, pneumothorax).
- Dullness: Quiet, high-pitched thudding sound found over solid organs (e.g., liver) or fluid/consolidation in lungs (e.g., pneumonia).
- Flatness: Very quiet, short thud heard over muscles and bones due to poor vibration transmission.
- Tympany: High-pitched, drum-like sound expected over hollow organs (e.g., stomach, bowels).
Clinical Examples & Application
- Resonance = healthy lung tissue.
- Hyper-resonance = air trapping, such as in COPD or pneumothorax.
- Dullness = solid organ (liver) or fluid-filled/consolidated lung (as in pneumonia).
- Flatness = muscle or bone.
- Tympany = hollow organs like stomach or intestines.
Key Terms & Definitions
- Indirect Percussion — Tapping on a finger placed over the body to assess underlying structures by sound.
- Resonance — Low-pitched, hollow sound; normal over lungs.
- Hyper-resonance — Booming, low-pitched sound; indicates excess air.
- Dullness — High-pitched, quiet thud; over solid organ or fluid.
- Flatness — Short, very quiet thud; over muscle or bone.
- Tympany — High-pitched, drum-like sound; over hollow organs.
Action Items / Next Steps
- Review percussion sound qualities and associated findings.
- Practice identifying percussion sounds on various body structures.