. Physical diagnosis . Position of the Right Hand During Percussion. mation about the condition of any sharply localized area. If a car-penter, in tapping the wall to find the position of the studs, strikestoo hard, he will fail to find the beam, because the blow deliveredover the spot behind which the beam is situated is so forcible as tobring out the resonance of the hollow parts around. It is the samewith medical percussion. Heavy percussion is always may be necessary where the muscles are very thick, but its value 1 See also below, page 136, the lung reflex. 124 PHYSICAL DIA
. Physical diagnosis . Position of the Right Hand During Percussion. mation about the condition of any sharply localized area. If a car-penter, in tapping the wall to find the position of the studs, strikestoo hard, he will fail to find the beam, because the blow deliveredover the spot behind which the beam is situated is so forcible as tobring out the resonance of the hollow parts around. It is the samewith medical percussion. Heavy percussion is always may be necessary where the muscles are very thick, but its value 1 See also below, page 136, the lung reflex. 124 PHYSICAL DIAGNOSIS. is then proportionately diminished. On the other hand, it is pos-sible to strike so lightly that no recognizable sound is elicited atall. The best percussion, therefore, is that which is just forcibleenough to elicit a clear sound without setting a large area of chestwall in vibration. The position of the patient above described applies to percus-sion of the front. When we desire to percuss the back, it is hn-. Fig. 78.—Proper Position of the Patient During Percussion of the Back. portant to get the scapulae out of the way as far as possible, sincewe cannot get an accurate idea of sounds transmitted through accomplish this, we put the patient in the position shown inFig. 78, the arms crossed upon the chest and each hand upon theopposite shoulder. The patient should be made to bend forward;otherwise the left hand of the percussor will be uncomfortably bentbackward and his attention thereby distracted (see Fig. 79). When the axillae are to be percussed, the patient should put thehands upon the top of the head. PERCUSSION. 125 (b) Auscultatory Percussion. If while percussing one auscults at the same time, letting thechest piece of the stethoscope rest upon the chest, or getting thepatient or an assistant to hold it there, the sounds produced bypercussion are greatly intensified, and changes in their volume,pitch, or quality are very readily appreciated. The blows
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