Indirect percussion

Indirect percussion is a common physical examination method. During percussion, the wrist is usually shaken to let the fingers tap the part that needs to be checked, and the sound emitted by the body after percussion is used to determine whether there is a disease. If you tap the patient's skin directly with your fingers, it is called direct percussion and is rarely used. If the operator's other hand is placed on the part to be tested, so that the testing finger taps on his own hand without direct contact with the patient's skin, it belongs to indirect percussion, which is more common.

Physical examination includes auscultation, palpation, percussion and other examination methods of the lungs, among which percussion is divided into direct percussion and indirect percussion. Indirect percussion is the most common examination method in clinical medicine. Indirect percussion is to place the tail end of the middle finger of the operator's right hand close to the position to be examined, and use the fingertip of the right middle finger to vertically tap the back of the second finger of the right middle finger. Generally, each percussion position should be tapped 2-3 times to listen to the sound, and at the same time, compare up and down at the corresponding position to accurately distinguish the changes in the percussion sound.

This type of percussion method can be used for percussion of multiple positions, including percussion of the lungs, identification of the lung borders, and identification of the heart borders. In addition, indirect percussion can also detect pleural effusion, pneumothorax and other diseases; percussion of the abdominal liver size can also be carried out using indirect percussion.

Lung percussion usually uses the first joint of the right middle finger as the plate finger, and the right middle finger is bent as the pressing finger. The plate finger is close to the sternum, and the pressing finger is used to tap continuously for two or three times. Percussion is divided into left lung and right lung. Generally, percussion is divided into three lines of percussion: the center of the neck, which is a line extending from the center of the neck parallel to the scapula; the center of the axilla, which is an extension line from the center of the axilla parallel to the scapula; and the scapula extension, a line extending downward from the lower angle of the scapula. Percussion of the lungs is generally clear, and it may be too clear if there is emphysema. When the percussion changes from clear or too clear to dull, it is the lower border of the lung, which is generally the 6th rib in the midclavicular line, the 8th rib in the midaxillary line, and the 10th rib at the scapula extension.