COPD. Comparative percussion of the lungs The task of comparative percussion is to compare percussion sounds over the lungs on the opposite parts of the chest, and also on neighboring areas on the one side. extreme obesity, the method of lung percussion may be. General signs such as fever and an accelerated respiratory and pulse rate increase the probability of a pneumonia. 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 used to determine whether underlying structures are fluid-filled, gas-filled, or solid. The sound should wax and wane. Dullness (shortening) of percussion sound is more, the more dense elements, the more lost airiness (fluid, infiltration, tumor tissue) in the percussion zone, which can detect this area at different depths with the help of different impact strengths: the stronger the shock (loud deep percussion), the more deeply located the compaction site is detected. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Auscultation over the same region should help to distinguish between these possibilities, as consolidation generates bronchial breath sounds while an effusion is … If you have a problem with coughing overnight, you can consider performing it right before you go to bed as well. Hence, percussion of it gives a resonance. More often, it is used as part of the clinical evaluation of the lungs and abdomen. Percussion. It is performed with the aim of loosening thick, sticky or retained secretions from the chest wall[1]. Percussion produces audible sounds (percussed notes) and palpable vibrations which can help to determine if the underlying lung tissue is filled with fluid, air or solid Posteriorly, the apexes of the lungs rise to about the level of T1. Debora Leader, a medical writer who specializes in chronic obstructive pulmonary diseases, suggests using electronic devices for chest percussion. BY DR.VIDHU MITTAL JUNIOR RESIDENT DEPTT. In the examination of the respiratory organs percussion occupies a special place. Percussion of a body part produces a sound, like playing a drum. Therefore, any dullness or hyper-resonance is indicative of lung pathology, such as pleural effusion or pneumothorax, respectively. Resonance - loud, low pitched hollow sound of a long duration. Then simply have the patient breath in and out deeply while continuing to percuss. Lungs sound hollow on percussion because they are filled with air. We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields. Percussion: Penetrates 5 - 6 centimeters into the chest cavity. The hand is cupped as if to hold water but with the palm facing down (as shown in the figure below). Percussion is another effective way to remove excess mucus from the lungs. Jelic S, Cunningham JA, Factor P. Clinical review: airway hygiene in the intensive care unit. There are abnormal rumbling sounds coming from your lungs. If it is difficult to make and hold the breath, this indicator is determined by successively using several regular inhalations and noting each the first percussion position of the lower pulmonary margin. General signs such as fever and an accelerated respiratory and pulse rate increase the probability of a pneumonia. The normal lung is less resonant than a pneumothorax as the lung tissue dampens the resonance slightly. May be impeded by a very thick chest wall. The iLive portal does not provide medical advice, diagnosis or treatment. Tympanic sounds are hollow, high, drumlike sounds. Percussion Note Common Causes Dull * Pleural effusion, presence of hepatic tissue, consolidation, pleural thickening Solid organ or fluid Resonant Normal lung Aerated lung tissue Hyperresonant Pneumothorax, COPD Hyperinflated lung tissue or air in the pleural space * Some authors refer to stony-dull as a separate percussion note. Postural drainage. When percussing boney areas … Evaluation of the effectiveness of manual chest physiotherapy techniques on quality of life at six months post exacerbation of COPD (MATREX): a randomised controlled equivalence trial. The cupped hand curves to the chest wall and traps a cushion of air to soften the clapping. This step helps identify areas of lung devoid of air. Dull percussive sounds are indicative of abnormal lung density. So for percussion, any air filled cavity will sound resonant (pneumothorax, normal lung). The indicated displacements of the lower border of the lungs are usually accompanied by a decrease in the mobility (excursion) of the lower pulmonary margin, which is determined by the average axillary line: in normal with respect to the VIII rib, the pulmonary margin drops by 4 cm at a deep inspiration and also by 4 cm at maximum expiration, , thus, the respiratory excursion of the lower pulmonary margin along this line is 8 cm. Since chest percussion therapy acts as a direct relief in the lungs, people who have cystic fibrosis can benefit significantly. It is used to determine the relative amounts of air, liquid, or solid material in the underlying lung. Full text Full text is available as a scanned copy of the original print version. Should you opt to use a mechanical airway clearance device instead of manual chest percussion, speak with your doctor about how to properly use it. The use of an electronic stethoscope with computerised analysis of the lung sounds might improve diagnostic accuracy. Hyperresonant sounds on lung percussion may indicate pneumothorax or chronic obstructive pulmonary disorder.