Percussion (medicine)

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 four methods of clinical examination, together with inspection, palpation and auscultation. It is done with the middle finger of one hand tapping on the middle finger of the other hand, which is placed firmly on the body over tissue, not bone.

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 more resonant sound indicates hollow, air-containing structures.

Percussion was initially used to distinguish between empty and filled barrels of liquor, and Dr. Leopold Auenbrugger introduced the technique to medicine.

Percussion of the thorax

It is used to diagnose pneumothorax, emphysema and other diseases. It can be used to access the respiratory mobility of the thorax.

Percussion of the abdomen

It is used to find whether any organ is enlarged and similar. It is based on the principle of setting tissue and spaces in between at vibration. The sound thus generated is used to determine if the tissue is healthy or pathological.

Percussion notes

Based on the auditory and tactile perception, the notes heard can be categorized as

• Tympanic
• Hyperresonant (pneumothorax)
• Normal resonance/ Resonant
• Impaired resonance (mass, consolidation)
• Dull (consolidation)
• Stony dull (pleural effusion)

See also

• Clinical examination
• Inspection (medicine)
• Palpation
• Auscultation
• Pleximeter

References

de:Perkussion (Medizin)