![]() ![]() ![]() As you move down the thorax, place your finger close to the vertebral line to avoid percussing over the bone of the scapula. On the posterior thorax, begin at the shoulders at the scapular line. Also remember that the posterior thorax is primarily lower lobes.ģ. Remember that the number of locations depends on the size of the thorax less locations are needed on a client with a smaller thorax (e.g., infants). See Figure 3.14 for the percussion pattern. Percuss in about four to eight locations on each side of the posterior thorax and then at three locations on the right lateral thorax and at two locations on the left lateral thorax. Then, perform a complete focused assessment on the respiratory system and check for other related cues.Ģ. If abnormal percussion sounds are noted, describe the sound and identify the location. If you do, the sound elicited over the heart (a dense organ) will be a dull high-pitched sound that quickly stops and over the ribs (composed of bone and cartilage will be a flat high-pitched sound that stops promptly with a very short duration). Keep in mind that you should not percuss over ribs or the heart. ![]() However, the notes typically don’t change with a client who is underweight. Percussion does not elicit reliable data when a client is overweight or obese because the adipose tissue modifies the normal resonance to a dull note. Listen for any abnormal percussion notes such as dull notes that can occur when the lung tissue is filled with fluid or solid matter (e.g., a tumour close to the chest wall, pneumonia, pleural effusion, atelectasis) or hyperresonance with lung conditions that lead to hyperinflation of part or all of a lung (e.g., emphysema, pneumothorax).With very young children under the age of about 5, you will hear a lower-pitch and booming sound (this is described as hyperresonance). The lung is an air-filled organ, so the normal percussion note over the lungs of older children, adolescents, and adults is resonance, which is a low-pitched and hollow sound.Ensure the client is in an upright position, and perform indirect percussion to evaluate the elicited sounds. The steps in percussing the posterior and lateral thorax are as follows (see Video 3.8):ġ. Posterior and Lateral Thorax – Percussion ![]()
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