Under the percussion ( "tapping") refers to the medicine , the tapping ( percuss ) the body surface of animals to diagnostic (as "knocking" in the physical therapy and therapeutic) purposes. It's part of the physical exam . The verb is percuss , the adjective by percussion or perkussorisch .
The tissue below the surface of the body is set vibrating. The resulting sound qualities provide information about the condition of the underlying tissue. The size and location of an organ (such as the liver ) or the air content of the tissue ( lungs ) can be estimated. Joseph Leopold von Auenbrugger (1722–1809) from Graz , who systematically developed it for the examination of the thorax and described it for the first time in 1761, is considered the modern founder of this technique, which has been known since antiquity and applied to the abdomen , for example .
The technique originally used by Leopold von Auenbrugger was direct percussion, in which the four fingers of one hand from the hand swinging in the wrist are tapped directly on the organ to be examined.
Indirect percussion was later developed, in which a finger of one hand (the so-called plessimeter finger) or a plessimeter is pressed flat on the surface of the body to be examined. A finger of the other hand or a percussion hammer is then tapped on that finger. The sound vibrations are transmitted from the plessimeter finger on top of the underlying tissue, which is set into natural vibrations. Diagnostic clues are obtained from the sound quality.
The most frequently used method is the finger-finger method, in which no aids are required: you place a finger (in the more delimiting percussion, the distal phalanx, in the more comparative percussion, the whole finger) on the surface of the body and tap with one finger another hand on it.
- Sonorous knocking sound: hollow tone audible when percussion of the healthy lungs
- Hypersonic knocking sound (louder and more hollow than sonorous knocking sound, so-called box tone ): Indication of excessive air content, for example in cases of emphysema , asthma , pneumothorax , etc.
- Muffled knocking sound (lower and shorter sound, comparable to that when knocking the thigh (thigh sound)): Damping as an indication of reduced air content or fluid accumulation, for example in ascites , pleural effusion , pneumonia , etc.
- tympanic knocking sound (hollow, almost musical timpani-like sound): tympanum as an indication of cavities, for example in caverns , gas-filled intestinal loop , stomach bladder
- U. Koehler, V. Gross, C. Reincke, T. Penzel: Sound diagnostic methods. The story of percussion and auscultation. In: Pneumologie , Volume 58, July 2004 edition, pp. 525-530. doi : 10.1055 / s-2004-818416
- Volker Hess: Percussion. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1121 f.
- Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition ibid. 1986, ISBN 3-13-352410-0 , pp. 16-20, 66-77, 86-98, 101-104, 156, 161, 164, 167 f., 173-177, 180 , 183 f., 186, 188, 190 f., 194, 232-235, 240-246, 248-250, 254, 256, 263, 265 and more often.
- L. Auenbrugger: Inventum novum ex percussione thoracis humani ut signo abstruso interni pectoris morbos detegendi.