What sound would be expected when percussing the chest of a client with emphysema
Main Body Show Percussion involves tapping the body to elicit sounds and determining whether the sounds are appropriate for a particular organ or area of the body. Try tapping different surfaces with your fingertips and compare the sounds: a firm hard surface like a wood desk or table, a thick textbook, a window, or even a drum. As you tap these surfaces, you can hear that each surface elicits a different sound based on the object’s consistency. This concept also applies to the body. Each body part that you percuss provides information about the consistency as well as the size and borders of the underlying structure. For example, the percussion sounds can tell you if the organ is:
Percussion can also help reveal the presence of masses, particularly if they are close to the surface of the body. There are three approaches to percussion, but the most widely used is indirect percussion, which is the application of a mediated force using parts of both of your hands. See Figure 1.8 demonstrating the technique of indirect percussion. Figure 1.8: Indirect percussion technique Indirect percussion is often used to assess the lungs and the abdomen (e.g., bowels, bladder, liver). The steps of this technique are as follows:
As a nurse, you need to become familiar with the expected percussion sounds so that you can identify what is normal and what is abnormal. See Figure 1.9 for the expected location of percussion sounds and Table 1.2 for an explanation of the types of percussion sounds heard including resonance, hyperresonance, tympany, dullness, and flatness. Figure 1.9: Expected location of percussion sounds Table 1.2: Percussion sounds
Another form of indirect percussion is used to assess the kidneys; this technique will be discussed in more detail when you learn about abdominal assessment. Direct percussion involves an unmediated approach with the use of only one of your hands; it is used to assess pain/tenderness associated with the sinuses or assessing the newborn/infant’s lungs. The steps of this technique involve flexing the index and pleximeter fingers of your dominant hand, and directly tapping the body’s surface with the tips of these fingers at a 90-degree angle. A third approach, tool-facilitated percussion, involves using an instrument to tap the body (e.g., a reflex hammer); this technique will be discussed in more detail when you learn about neurological assessment. You must keep your nails trimmed short to perform indirect and direct percussion so that you can perform the technique accurately and elicit a useful sound. It takes practice to perfect the technique. Keep in mind the phrase “don’t be a woodpecker” – when percussing, just use two taps on the pleximeter finger in each location, and focus on listening for sounds. With children, it is important to engage the client and incorporate play when appropriate. Percussion is one of the least used of all physical assessment techniques. It is a technique that is better confirmed using more accurate tests such as an X-ray. However, when such diagnostic tests are not readily available, such as in rural, remote or underdeveloped regions, percussion is an important non-invasive technique. Additionally, percussion is not effective when the client has a significant amount of adipose tissue or is very muscular, as these types of tissues modify the sounds you expect to hear. What sound is heard in emphysema?The inflammation that comes with COPD can affect both your large and small airways by causing them to narrow. A wheezing sound is the vibration of air through these narrowed airways. This wheezing sound can sometimes be heard when you breathe in. In most cases, though, it's louder when you're breathing out.
What percussion sounds will you hear in patient with COPD in?The percussion sound is hyperresonant, if the sound is more hollow than normal. [75] The characteristic finding in COPD is a generalized and symmetrical hyperresonance note.
What is heard when you Percuss the lung of a patient with emphysema?Hyperresonant sounds may also be heard when percussing lungs hyperinflated with air, such as may occur in patients with COPD, or patients having an acute asthmatic attack. An area of hyperresonance on one side of the chest may indicate a pneumothorax. Tympanic sounds are hollow, high, drumlike sounds.
What sound would be expected when purchasing the chest of a client with emphysema?Crepitus in the lungs refers to the sound and sensation associated with subcutaneous emphysema, a condition in which air is trapped under the skin. It is characterized by the palpable or audible popping, crackling, grating, or crunching sensation that can occur when air is pushed through the soft tissue in the chest.
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