Percussion of the lungs, along with auscultation,It is considered the most important method of clinical examination of patients with respiratory diseases. Percussion is still widely used in clinical practice, despite the emergence of new diagnostic methods of instrumental research.
A percussion or percussion method has been proposed.by the Austrian physician Auenbrugger in 1761, and entered into clinical practice by the French physician Corvizar. Percussion of the lungs, like other organs, is done by hand, does not require the use of additional tools, is simple and highly informative.
The method is based on the fact that internal organs withpercussion give different height sounds. The qualities of these sounds, called percussion sounds, depend on the content and density of the tissue of the organs. During the percussion of parts of the body that do not contain air, a dull percussion sound is produced. A similar sound is produced, for example, by percussion of the liver. With the percussion of organs containing a lot of air, the sound is ringing. Thus, the change in percussion tone can be judged on the changes in the internal organs, their location.
Normal over the entire surface of the lungs due toA large air content is determined by a sonorous sound. This sound is called clear pulmonary. With the development of various diseases, the air content in the lungs may increase or decrease, and the percussion sound changes accordingly.
Changes in percussion sound occur in the direction of dulling or in the direction of tympanitis, that is, increase in voicing. The nature of the sound depends on the amount of air and density of the underlying tissues.
Притупление перкуторного звука бывает при collecting exudate in the pleural cavity, reducing the amount of air in the lung tissue due to pneumosclerosis, with the development of inflammation of various origins, the growth of the tumor.
The increase in ringing when percussion is observedwith accumulation of excess air in the lungs, which happens with emphysema or bronchial asthma. High percussion sound is determined over large cavities in the lungs filled with air (tubercular cavities, exposed lung abscess, pneumothorax).
Topographic percussion of the lungs is applied,primarily to determine the boundaries of the lungs. First, determine the boundaries of the tops of the lungs. Normally, the height of the tops is defined above both clavicles by 3-5 cm. Then they find the lower limit, starting from the right half. With the expansion of the lungs, their lower limit falls, and when the diaphragm is high, occurring during pregnancy, ascites, meteorism, on the contrary, rises. Topographic percussion of the lungs makes it possible to determine the respiratory excursion of the lungs, that is, their active mobility, which is the difference between the lower border of the lungs during maximum inhalation and exhalation. In healthy people, the excursion of the lungs is 4-8 cm. In case of severe inflammatory processes in the lungs, emphysema, pleurisy, pneumosclerosis, the excursion of the lungs is reduced. This occurs as a result of a decrease in the elasticity and ability of the lung tissue to straighten out during inhalation.
Comparative lung percussion successfullyused to diagnose pathological processes in any part of these organs. In this case, the percussion tone is compared with the normal one on symmetric areas. In healthy people, it is the same in the right and left half of the chest.
So the lung percussion performed incomplex with other main methods of clinical examination of the patient, allows you to quickly identify changes in lung tissue and make a preliminary diagnosis of the disease.
