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, together 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 nonstriking finger (known as the pleximeter) is placed firmly on the body over tissue.
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. As well as producing different notes which can be heard they also produce different sensations in the pleximeter finger.
A beginner’s guide to percussion as part of a medical examination — perfect for the medical student on their first placement. Far from comprehensive, but an excellent starting point if you’re not quite sure what approach to take. Part of our series on basic clinical examination.
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