Percussion

Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the five methods of clinical examination, along with inspection, palpation, auscultation, and inquiry. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The non-tapping hand is placed on the body with the middle finger pressed firmly on the surface.

Types of Percussion

There are two types of percussion: direct, which uses only one or two fingers, and indirect, which uses the middle/flexor finger. There are four types of percussion sounds: resonant, hyper-resonant, stony dull or dull. A dull sound indicates the presence of a solid mass under the surface. A hollow or resonant sound indicates that there is air present. A hyper-resonant sound suggests there is an excess of air. A stony dull sound is when there is fluid in the underlying area.

Medical Uses

Percussion is used to diagnose the condition of the lungs, heart, and abdomen. It can also be used to identify the level of the diaphragm, or to identify the borders of an organ. It is also used to diagnose pneumothorax, emphysema, and other conditions.

History

Percussion was first described by Hippocrates, but it was not until the 19th century that it became a standard part of the clinical examination. The technique was further developed by Joseph Leopold Auenbrugger, a Viennese physician, and later by Pierre Adolphe Piorry, a French physician.

See Also

• Clinical examination
• Hippocrates
• Joseph Leopold Auenbrugger
• Pierre Adolphe Piorry

References

Percussion Resources
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