PERCUSSION OF CHEST
To perform a percussion examination, strike the surface of the body. When this
is done, various sounds can be heard. The sounds are different depending on the
underlying structure of the body. There are two reasons to use percussion as an
examination technique. First, percussion results in setting the chest wall and underlying
tissues in motion. This produces sounds that can be heard. Second, percussion
sounds can be divided into four recognizable notes. Train your ear to recognize the
pitch and duration of these notes. The sound can indicate whether the underlying
tissues are filled with air, filled with fluid, or solid. NOTE: Percussion will set tissues in
motion only about five to seven centimeters into the chest, so the percussion
examination technique is not a way to detect lesions that are very deep.
Table 2-1. Table of percussion notes.
a. Procedure. In order to perform the percussion examination technique, strike
the stationary finger of one hand with a flexed finger of the other hand. The technique,
described here, can be practiced on any surface. Here are the key points:
(1) Firmly rest the first joint of the middle finger of one hand on the patient's
chest, but don't let the rest of the hand touch the chest (figure 2-6).
Figure 2-6. Hand and finger placement.