Percussion

Definition

Percussion is an assessment technique in which the nurse taps on the body surface with a finger to produce sounds that indicate the density of underlying structures.

Percussion Tones

• Resonance: Low-pitched, hollow. Normal over lungs.
• Hyperresonance: Booming, low-pitched, such as emphysema, pneumothorax.
• Tympany: Drum-like, such as air-filled viscera (stomach, bowel).
• Dull: Thud-like, such as solid organs, fluid (consolidation, pleural effusion).
• Flat: Very dull, such as muscle, bone, large tumors.

Technique

Place non-dominant middle finger on surface; tap middle finger of dominant hand on distal joint of placed finger. Strike 2 to 3 times at each location; move systematically and compare sides.

Nursing Considerations

Use to detect pleural effusion (dullness), pneumothorax (hyperresonance), bladder distention (dullness above pubis), ascites (shifting dullness).

NCLEX Relevance

Dullness over lung = consolidation or fluid. Tympany over abdomen = air/gas.