Handbook of Clinical Diagnostics by Xue-Hong Wan & Rui Zeng

Author:Xue-Hong Wan & Rui Zeng
Language: eng
Format: epub
ISBN: 9789811376771
Publisher: Springer Singapore

45.4.3.1 Percussion Method

Usuallywe employ indirect percussion for relative cardiac dullness. The examiner hyperextends the left middle finger as the pleximeter finger, parallel to intercostal space when a patient lies supine on an examining table, and perpendicular when patient sits (Fig. 45.26). During percussion, the examiner should press pleximeter finger firmly on the surface that is to be percussed, and put the right forearm quite close to the surface with the hand cocked upward, then move medially until cardiac dullness is noticed. The border is perceived better by repetitive thumping the point at which the percussion note becomes dull. Light percussion will mostly produce a clear cardiac border, but a heavier percussion may be neccessary for people with a thick chest wall.

Fig. 45.26Heart border percussion

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