Indirect Percussion

Indirect percussion is a physical examination technique that uses tapping to assess the density and location of structures beneath the body surface. In clinical practice, the examiner places one finger firmly against the skin and strikes it with a second finger, generating vibrations whose resulting sound and feel vary with air-filled, fluid-filled, or solid tissues. By comparing resonance, dullness, intensity, and the boundaries of percussion notes across adjacent areas, clinicians can identify changes associated with lung aeration, pleural fluid, organ enlargement, or abdominal masses. This rapid, noninvasive method complements inspection, palpation, auscultation, and imaging by helping prioritize further evaluation and monitor clinical findings.

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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...

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...

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...

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ELISA Assays: Indirect, Sandwich, and Competitive

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Source: Whitney Swanson1,2, Frances V. Sjaastad2,3, and Thomas S. Griffith1,2,3,4 1 Department of Urology, University of Minnesota, Minneapolis, MN 55455 2 Center for Immunology, University of Minnesota, Minneapolis, MN 55455 3 Microbiology, Immunology, and Cancer Biology Graduate Program, University of Minnesota, Minneapolis, MN 55455 4 Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 Enzyme-linked immunosorbent assay (ELISA) is frequently used to measure the presence...

Assessment of the Abdomen II: Percussion

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2025

Percussion is a fundamental technique used to assess the liver, spleen, and abdominal organs by tapping the abdomen and interpreting the resulting sounds. This method helps identify fluid, distention, and masses through variations in sound, such as the high-pitched tympany of air-filled areas and the dullness of solid masses. Understanding how to percuss these organs provides valuable information for healthcare professionals in diagnosing conditions early. Percussion Percussion is an essential...

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