Percussion: Physical Exam Technique for Assessing Tissue Density
Percussion = tapping body surface (finger/plexor) to elicit sound reflecting underlying tissue density/air content.
Key Notes
- Resonant: Air-filled (normal lung, pneumothorax ↑)
- Hyperresonant: Emphysema, pneumothorax
- Dull: Fluid/solid (consolidation, effusion, mass, liver/spleen)
- Flat: Very dense (muscle, bone, large effusion)
- Tympany: Gas-filled (stomach, bowel)
Applications
- Lung: Compare sides, map borders
- Abdomen: Liver span, splenomegaly, free air, masses
- Heart: Border estimation (limited utility vs. imaging)
- Sinuses: Frontal/maxillary tenderness/dullness
Technique: Hyperextend middle finger, strike distal phalanx with opposite middle finger tip; wrist motion, not arm. Practice for consistency.
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