Percussion in Physical Assessment — Key Points
Percussion in Physical Health Assessment
Percussion is the third technique in IPPA (Inspection, Palpation, Percussion, Auscultation).
Purpose: strike body to elicit a sound from a hollow organ; determine location, shape, size, and tissue density.
Communication: tell patient what/why; invite pain feedback; be systematic.
Types of Percussion
Direct percussion: tapping directly with fingertips on area; used for periorbital sinuses or newborn lungs; tap moderately.
Blunt percussion: nondominant palm flat on surface; strike with dominant closed fist; assess pain/tenderness in liver, gallbladder, kidneys.
Indirect percussion: most common; place middle finger of non-dominant hand on body; strike with dominant middle finger using wrist motion; two quick taps; listen to tone; ensure quick taps to avoid dampened tone.
What Percussion Reveals
Sound and dullness help determine location, size, shape; note changes at organ borders.
Density: solid vs air vs fluid.
Depth: sound penetrates approx. ; detects superficial abnormalities.
Tone reflects density; different tones help identify tissue state.
Reflexes: percussion hammer elicits deep tendon reflexes.
Pain: percussion-induced pain may indicate inflammation.
Practical Tips
Use quick, sharp taps; wrist motion; avoid too light or too strong.
Nails trimmed for best contact.
Be systematic to maximize patient feedback.