PARS Overview 06 Percussion

Summary

This video script explains the technique of percussion in clinical examinations, where tapping the body surface with fingers produces sound waves that help assess underlying tissues. It covers both direct and indirect percussion methods, the sounds produced by percussion, such as tympany, hyperresonance, and dullness, which indicate various conditions like air, fluid, or solid organs. The script highlights common errors in technique and how to avoid them. Fist percussion is also described as a method for detecting tenderness in specific organs like the liver and kidneys. This information is crucial for clinicians in diagnosing and assessing organ conditions.

Takeaways

• 😀 Percussion is a technique of striking the body surface to produce sound waves, which help in diagnosing conditions related to fluid, air, or solid organs.
• 😀 The sound produced by percussion depends on the density of the underlying tissue.
• 😀 Percussion can be used to detect fluid or air in hollow organs like the lungs or stomach, and to determine the borders of solid organs like the heart or liver.
• 😀 There are two methods of percussion: direct and indirect.
• 😀 The direct method involves striking the body surface directly with fingers or the fist, most commonly using one or two fingertips.
• 😀 Indirect percussion, the more commonly used method, requires both hands. The non-dominant hand's fingers are spread with the middle finger flat against the body, while the dominant hand strikes the non-dominant finger.
• 😀 The movement in indirect percussion should be swift, originating from the wrist, and not from the elbow or shoulder.
• 😀 Percussion sounds vary in pitch and intensity, with common sounds being tympany, hyper-resonance, resonance, dullness, and flatness.
• 😀 Tympany is a loud, high-pitched sound, typical over an air-filled stomach.
• 😀 Hyper-resonance is a very loud, low-pitched sound, often heard over an emphysematous lung.
• 😀 Dullness and flatness are heard when solid organs or muscle are percussed, with dullness indicating soft organs like the liver and flatness suggesting muscle or dense structures.
• 😀 Common errors in percussion include improper pressure, incorrect finger positioning, and incorrect striking methods (e.g., tapping with the elbow or shoulder rather than the wrist).
• 😀 Fist percussion is commonly used to assess tenderness in organs like the liver, gallbladder, or kidneys. It involves striking the body with the ulnar aspect of the fist.

Q & A

What is percussion in medical practice?

Percussion is the process of striking the body surface with a finger or fist to produce sound waves, helping to assess the underlying tissue's density and determine the presence of fluid, air, or solid organs.

What are the two methods of performing percussion?

The two methods of performing percussion are direct percussion, where the body surface is struck with the fingers or fist, and indirect percussion, which involves using both hands.

How is direct percussion performed?

Direct percussion involves striking the body surface with one or two fingertips or the ulnar surface of the fist, with the goal of producing sound waves.

What is the technique for indirect percussion?

Indirect percussion involves using both hands: the non-dominant hand's middle finger lies flat on the body surface, while the dominant hand's middle finger strikes the non-dominant finger at the interphalangeal joint.

What is the correct movement when performing percussion?

The correct movement is swift and fluid, originating from the wrist, with the finger snapping back after striking the body surface.

What are the different percussion sounds and their meanings?

The percussion sounds include: 'Tympany' (loud, high-pitched, drum-like sound, heard over an air-filled stomach), 'Hyperresonance' (very loud, low-pitched sound, heard in emphysema), 'Resonance' (loud, low-pitched sound, heard in healthy lung fields), 'Dullness' (soft to moderate intensity, heard over solid organs like the liver), and 'Flat' (soft, high-pitched sound, heard over muscles).

What is the purpose of percussion in assessing the lungs or abdomen?

Percussion is used to determine the presence of fluid or air in hollow organs, such as the lungs and stomach, and to assess the borders of solid organs like the heart or liver.

What are some common errors made during percussion?

Common errors include failing to exert firm pressure with the non-dominant hand, not separating the hammer finger from other fingers, using the elbow or shoulder instead of the wrist for movement, tapping with just the hammer finger, and striking with the pad instead of the tip of the hammer finger.

How can you practice percussion techniques?

You can practice percussion techniques on yourself or by tapping on the walls of a room to observe where the supporting structures are located.

What is fist percussion and when is it used?

Fist percussion involves using the ulnar aspect of the fist to deliver a firm but not too hard blow to specific areas, typically used to elicit tenderness in the liver, gallbladder, or kidneys.