Abdominal percussion sound

Abdominal percussion examination is an auxiliary examination method for checking whether the abdomen is normal. In the normal abdomen, except for the liver and spleen, the percussion is voiced or actual, and the rest of the percussion is drum sound. Apparent drum sounds can be found in high gastrointestinal flatulence, artificial pneumoperitoneum and gastrointestinal perforation. When the liver and spleen or other substantial organs are extremely enlarged, intra-abdominal tumors and a large amount of ascites, the drum sound range is reduced, and the lesions may have dull or real sound. Through this examination, the lesion and the corresponding symptoms can be judged. Basic Information Specialist classification: Digestive examination classification: other examinations Applicable gender: whether men and women apply fasting: not fasting Reminder: The change of the drum sound range during inspection is an abnormal situation: (1) The drum sound range is reduced. When the liver, spleen or other organs are extremely swollen, intra-abdominal tumor or a large amount of ascites, the lesion may have dull or real sound. , causing the drum sound range to shrink. (2) Increased drum sound range or abnormal drum sound When the gastrointestinal tract is highly flatulent, artificial belly and gastrointestinal perforation, the drum sound range is increased or appears in the area where there should be no drum sound (such as the liver turbidity boundary). Normal value Under normal circumstances, the distribution of normal abdominal percussion sounds in most areas of abdominal percussion are drum sounds, only the liver and spleen, the enlarged part of the bladder and uterus, and the lumbar sounds on both sides of the abdomen. The organs that can appear at the time of percussion are normally unvoiced, and the unvoiced sound is a percussive sound with low pitch, strong sound, and long sound. Clinical significance Abnormal result Because the elasticity or gas content of the tissue or organ of the human body being attacked is different in depth, it can produce different percussion sounds, which are clinically distinguished as unvoiced, drum sound, voiced sound, real sound and over-voiced sound. Kind. (1) The unvoiced sound is a percussive sound with low pitch, strong sound, and long sound. It is produced when slamming the elastic and gas-containing organs, and can be seen in the chest when the lung tissue is elastic and the gas content is normal. (2) Dullnote is a high-pitched, low-pitched sound with a short sound. Produced when a sniper covers a parenchy body with a small amount of gas-containing tissue. Seen in the chest and percussion of the liver and heart, it can also occur when the pneumonia is reduced due to the lack of air in the chest. (3) The flat note is a percussion sound with a higher pitch, a lower sound, and a shorter sound. In order to attack the substantial organs without gas, such as liver and muscle, a large amount of pleural effusion and complete lung consolidation can also occur. (4) Drumpet (tympante) is a kind of bass that is stronger than the unvoiced sound and has a long and harmonious sound. It appears when slamming a cavity organ containing a large amount of gas. Normal people can see it in the stomach area and abdominal percussion. Patients with pneumoperitoneum or large lung cavities. The change in the drum sound range during the inspection is an abnormal situation: (1) Drumming range is reduced When the liver, spleen or other organs are extremely swollen, intra-abdominal tumors or a large amount of ascites, the lesions may have dull or real sounds, resulting in a narrow drum sound range. (2) Increased drum sound range or abnormal drum sound When the gastrointestinal tract is highly flatulent, artificial belly and gastrointestinal perforation, the drum sound range is increased or appears in the area where there should be no drum sound (such as the liver turbidity boundary). (5) Hyperresonante (hyperresonante) is a percussion sound between the unvoiced and the drum sound, which can be seen in patients with emphysema whose lung tissue elasticity is weakened and the gas content is increased. People who need to be examined: routine physical examination items, abnormal abdominals. Precautions Requirements for inspection: 1 The sniper strength should be appropriate during the percussion, and should not be too light or too heavy; 2 When the right middle line and the right shoulder line are diagnosed, the left side of the subject can be taken; 3 Because the lower hepatic border overlaps with the organs such as the stomach and colon, it is difficult to accurately locate the percussion, so palpation or hearing can be used. Inspection process I. Indirect percussion method: also referred to as the percussion method is the most commonly used percussion method in clinical practice. The method is: use the left hand finger and the last two knuckles to stick to the examined part, and the other fingers should be picked up slightly and not in contact with the body surface. The right hand refers to the natural bending, and the fingertip of the middle finger vertically slams the back of the second phalanx of the left middle finger. When slamming, the metacarpophalangeal joint and wrist joint should be mainly used. The sniper should be flexible and flexible. Do not rest the right middle finger on the back of the left middle finger. For each percussion site, it should be continuously slammed 2-3 times, the force should be even, so that the percussion sound is basically the same, and at the same time, the corresponding parts are compared to correct the change of the percussion sound. 2. Deep airless tissue 1. Light percussion method: Applicable to lesions with small, light and superficial lesions, and the lesions are located in the cavity containing gas or the surface of the lesion is covered by gas-bearing tissue. The above situation, such as percussion is too hard to easily cause vibration of the tissue around the lesion, and affecting the nature of the percussion is not conducive to judgment. 2. Repeated diagnosis: for deep or large areas of disease and obesity, muscle developed. In the above situation, only a strong sniper can cause vibrations in the deep lesions or under the thick body wall to make a sound for diagnosis. 3. The lightest diagnosis method: also known as the threshold diagnosis method. At the time of percussion, the first interphalangeal joint of the left middle finger is flexed to a right angle, the fingertip touches the part of the bedding, and the finger is gently tapped with the tip of the right hand. This method is rarely used clinically, and can sometimes be used for percussion in the heart and heart. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention. Adverse reactions and risks Nothing.