Abdominal Percussion
Abdominal Percussion - Related Videos
06:50
Abdominal Exam II: Percussion
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2023
Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA Medical percussion is based on the difference in pitch between the sounds elicited by tapping on the body wall. The auditory response to tapping depends on the ease with which the body wall vibrates, and is influenced by underlying organs, strength of the stroke, and the state of the body wall. There are three main medical percussion sounds: resonance (heard over lungs), tympany (heard over...
08:45
Percussion
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2023
Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT Simply stated, percussion refers to the striking of one object against another to produce sound. In the early 1700s, an Austrian inn-keeper's son, named Leopold Auenbrugger, discovered that he could take inventory by tapping his father's beer barrels with his fingers. Years later, while practicing medicine in Vienna, he applied this technique to his patients and published the first...
13:32
Abdominal Exam IV: Acute Abdominal Pain Assessment
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2023
Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to the abrupt onset of severe abdominal pain with features suggesting a surgically intervenable process. The differential diagnosis of acute abdominal pain is broad; thus, clinicians must have a...
07:54
Respiratory Exam II: Percussion and Auscultation
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2023
Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center Learning the proper technique for percussion and auscultation of the respiratory system is vital and comes with practice on real patients. Percussion is a useful skill that is often skipped during everyday clinical practice, but if performed correctly, it can help the physician to identify underlying lung pathology. Auscultation can provide an almost immediate diagnosis for a number of acute...
08:25
Abdominal Exam III: Palpation
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2023
Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA Abdominal palpation, if performed correctly, allows for examination of the large and relatively superficial organs; for a skilled examiner, it allows for assessment of the smaller and deeper structures as well. The amount of information that can be obtained by palpation of the abdominal area also depends on the anatomical characteristics of the patient. For example, obesity might make...
FAQs
Tympany generally indicates gas-filled bowel beneath the abdominal wall, whereas dullness is associated with fluid, solid organs, or masses. The examiner interprets these notes according to their location and distribution rather than treating either sound as a diagnosis by itself. This distinction helps identify areas that may warrant closer assessment with other examination methods or additional testing.
Regional comparison provides a reference for judging whether a percussion note is expected or unusual. Differences in tone can help estimate the boundaries of abdominal organs and reveal shifts in the relative amounts of air, fluid, and solid tissue. This comparative approach is especially useful when assessing liver size, abdominal distention, or possible organ enlargement.
The sound depends largely on what lies beneath the abdominal wall. Air produces a tympanic quality, while fluid and solid structures produce dullness. Because abdominal regions can contain different combinations of bowel gas, organs, fluid, or masses, the resulting pattern may vary from one area to another. Interpreting these patterns connects the physical finding with underlying composition.
The examiner taps the abdominal wall and listens for changes in percussion quality across different regions. Findings are then compared with observations from inspection, auscultation, and palpation rather than interpreted in isolation. This integrated workflow allows percussion patterns to contribute to the broader physical examination and helps determine whether an abnormal finding deserves additional diagnostic evaluation.
Abdominal percussion can support assessment when the clinician needs information about liver boundaries, abdominal distention, ascites, or abnormal organ enlargement. The technique offers a way to compare the expected distribution of tympany and dullness with the observed pattern. Its findings can guide the decision to pursue additional diagnostic testing when the examination suggests an abnormality.
Percussion findings provide physical examination clues rather than a complete explanation of abdominal disease. An unusual distribution of tympany or dullness may suggest altered gas, fluid, organ, or mass patterns and can be considered alongside inspection, auscultation, and palpation. When the combined assessment raises concern, these findings help determine whether additional diagnostic testing is warranted.