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{{Short description|Clinical examination technique}}
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'''Percussion''' is a technique of [[clinical examination]].
'''Percussion''' is a method of tapping on a surface to determine the underlying structure, and is used in [[clinical examination]]s to assess the condition of the [[human thorax|thorax]] or [[abdomen]]. It is one of the four methods of clinical examination, together with [[inspection (medicine)|inspection]], [[palpation]] and [[auscultation]]. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The non striking finger (known as the [[pleximeter]]) is placed firmly on the body over tissue. When percussing boney areas such as the [[clavicle]] the spleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of [[Tuberculosis|TB]].<ref>Owen Epstein, G. David Perkin, John Cookson, David P. de Bono ''Pocket Guide to Clinical Examination'' Third Edition Mosby 2004 ISBN 0-7264-3230-9 {{Please check ISBN|reason=Check digit (9) does not correspond to calculated figure.}}</ref>▼
==Overview==
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.▼
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▲There are two types of percussion: direct, which uses only one or two fingers
Percussion was at first used to distinguish between empty and filled [[barrels]] of [[liquor]], and Dr. [[Leopold Auenbrugger]] is said to be the person who introduced the technique to modern medicine, although this method was used by [[Avicenna]] about 1000 years before that for medical practice such as using percussion over the stomach to show how full it is, and to distinguish between [[ascites]] and [[tympanites]].<ref>{{cite web|url=https://archive.org/details/AvicennasCanonOfMedicine|title=Avicenna's Canon Of Medicine|last=Cibeles Jolivette Gonzalez|access-date=17 April 2018|via=Internet Archive}}</ref>
== Percussion of the thorax ==▼
It is used to diagnose [[pneumothorax]], [[emphysema]] and other [[disease]]s. It can be used to assess the respiratory mobility of the thorax.
==
It is used to find whether any [[organ (anatomy)|organ]] is enlarged and similar (assessing for organomegaly). 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.
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Based on the auditory and tactile perception, the notes heard can be categorized as
*
* Hyperresonant (pneumothorax), said to sound similar to percussion of puffed up cheeks.
* Normal resonance/ Resonant, the sound produced by percussing a normal chest.
* Impaired resonance (mass, consolidation) lower than normal percussion sounds.
* Dull (consolidation), similar to percussion of a mass such as a liver.
* Stony dull, the sounds produced on percussion from the [[pleximeter]] with no contribution from the underlying area.
Percussion may induce pain, this is often also noted as it can indicate underlying pathology.
==References==
{{Reflist}}
{{Physical exam}}
{{Respiratory system symptoms and signs}}
{{Authority control}}
{{DEFAULTSORT:Percussion (Medicine)}}
[[Category:Physical examination]]
[[Category:Audible medical signs]]
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