{"id":252,"date":"2021-08-28T02:29:35","date_gmt":"2021-08-28T06:29:35","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/anterior-thorax-percussion\/"},"modified":"2024-06-28T16:58:01","modified_gmt":"2024-06-28T20:58:01","slug":"anterior-thorax-percussion","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/anterior-thorax-percussion\/","title":{"raw":"Anterior Thorax - Percussion","rendered":"Anterior Thorax &#8211; Percussion"},"content":{"raw":"<p style=\"text-align: left\"><span style=\"color: #000000\">Percussion of the anterior thorax involves the following steps (see <strong>Video 12<\/strong>):<\/span><\/p>\r\n\r\n<ol>\r\n \t<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Ensure the client is in an <strong>upright position<\/strong>, and then perform <strong>indirect percussion<\/strong> to evaluate the elicited sounds.<\/span><\/li>\r\n \t<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Percuss in about four to eight locations on each side of the anterior thorax. See <strong>Figure 19<\/strong>\u00a0for the <strong>percussion pattern<\/strong>.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">On the <strong>anterior thorax<\/strong>, begin at the apices and move down to the bases, comparing side to side. In the supraclavicular region, start at the midclavicular line. As you move inferior to the clavicle, you should shift medially slightly, and then stay close to the sternum to avoid the breast tissue. Toward the bases, percuss close to the sternal line and move laterally.<\/span>\r\n<ul>\r\n \t<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Keep in mind that the elicited sound will become dull as you percuss over the heart (second to fifth intercostal space on left side). Also, avoid percussing over breast tissue as this will elicit a dull sound, and avoid percussing over clavicles and ribs because this will elicit a flat note. To avoid the ribs, rock your finger back and forth to ensure you are in an intercostal space. Typically, you will skip the percussion step when the client has a muscular chest or a lot of adipose tissue as this will modify the normal resonant sound to a flat sound.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">4. Note the <strong>findings<\/strong><\/span><\/p>\r\n\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cResonance heard throughout lungs on anterior thorax.\u201d<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cDominant sound of resonance heard throughout lungs on anterior side except an area of 3 cm<sup>2<\/sup> on left sternal border between clavicle and second rib.\u201d<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/12\/Anterior-Thorax-Percussion-244x300.jpg\" alt=\"Blue dots outlining the percussion sites and pattern on a person's chest.\" width=\"400\" height=\"492\" class=\"alignnone wp-image-1870\" \/>\r\n\r\n<strong><span>Figure <\/span><span>19<\/span>:<\/strong><span> Percussion pattern for anterior thorax\u00a0<\/span>\r\n\r\n<span style=\"color: #000000\">Photo by<\/span> <a href=\"https:\/\/unsplash.com\/@oh_gosh\">Seyi Ariyo<\/a> <span style=\"color: #000000\">on<\/span> <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span>\r\n\r\n&nbsp;\r\n\r\nhttps:\/\/youtu.be\/QcklK57xkwI\r\n\r\n<strong>Video 12<\/strong>: Percussion of anterior thorax\r\n<h2 style=\"text-align: left\"><span style=\"color: #000000\"><strong>Activity: Check Your Understanding<\/strong><\/span><\/h2>\r\n<p style=\"text-align: left\"><span>[h5p id=\"211\"]<\/span><\/p>\r\n&nbsp;\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Attribution Statement: The description of percussion and the technique is taken and modified from chapter 5.<\/span><\/p>","rendered":"<p style=\"text-align: left\"><span style=\"color: #000000\">Percussion of the anterior thorax involves the following steps (see <strong>Video 12<\/strong>):<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Ensure the client is in an <strong>upright position<\/strong>, and then perform <strong>indirect percussion<\/strong> to evaluate the elicited sounds.<\/span><\/li>\n<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Percuss in about four to eight locations on each side of the anterior thorax. See <strong>Figure 19<\/strong>\u00a0for the <strong>percussion pattern<\/strong>.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">On the <strong>anterior thorax<\/strong>, begin at the apices and move down to the bases, comparing side to side. In the supraclavicular region, start at the midclavicular line. As you move inferior to the clavicle, you should shift medially slightly, and then stay close to the sternum to avoid the breast tissue. Toward the bases, percuss close to the sternal line and move laterally.<\/span>\n<ul>\n<li style=\"font-weight: 400;text-align: left\"><span style=\"color: #000000\">Keep in mind that the elicited sound will become dull as you percuss over the heart (second to fifth intercostal space on left side). Also, avoid percussing over breast tissue as this will elicit a dull sound, and avoid percussing over clavicles and ribs because this will elicit a flat note. To avoid the ribs, rock your finger back and forth to ensure you are in an intercostal space. Typically, you will skip the percussion step when the client has a muscular chest or a lot of adipose tissue as this will modify the normal resonant sound to a flat sound.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p style=\"text-align: left\"><span style=\"color: #000000\">4. Note the <strong>findings<\/strong><\/span><\/p>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Normal findings might be documented as: \u201cResonance heard throughout lungs on anterior thorax.\u201d<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Abnormal findings might be documented as: \u201cDominant sound of resonance heard throughout lungs on anterior side except an area of 3 cm<sup>2<\/sup> on left sternal border between clavicle and second rib.\u201d<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/12\/Anterior-Thorax-Percussion-244x300.jpg\" alt=\"Blue dots outlining the percussion sites and pattern on a person's chest.\" width=\"400\" height=\"492\" class=\"alignnone wp-image-1870\" \/><\/p>\n<p><strong><span>Figure <\/span><span>19<\/span>:<\/strong><span> Percussion pattern for anterior thorax\u00a0<\/span><\/p>\n<p><span style=\"color: #000000\">Photo by<\/span> <a href=\"https:\/\/unsplash.com\/@oh_gosh\">Seyi Ariyo<\/a> <span style=\"color: #000000\">on<\/span> <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Percussion of Anterior Thorax\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/QcklK57xkwI?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong>Video 12<\/strong>: Percussion of anterior thorax<\/p>\n<h2 style=\"text-align: left\"><span style=\"color: #000000\"><strong>Activity: Check Your Understanding<\/strong><\/span><\/h2>\n<p style=\"text-align: left\"><span><\/p>\n<div id=\"h5p-211\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-211\" class=\"h5p-iframe\" data-content-id=\"211\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ch 3 - Posterior and Lateral Thorax - Percussion\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Attribution Statement: The description of percussion and the technique is taken and modified from chapter 5.<\/span><\/p>\n","protected":false},"author":34,"menu_order":14,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[],"contributor":[72],"license":[56],"class_list":["post-252","chapter","type-chapter","status-publish","hentry","contributor-december-2021","license-cc-by-nc"],"part":224,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/252","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":6,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/252\/revisions"}],"predecessor-version":[{"id":2811,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/252\/revisions\/2811"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/224"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/252\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=252"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=252"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=252"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=252"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}