Percussion of the heart - a method for determining the boundaries of an organ

Percussion of the heart is used to determine the position, magnitude, and configuration of the heart. Percussion can be carried out in the vertical and horizontal position of the patient. It should be taken into account that the measured size of the heart in the vertical position is less than in the horizontal one. This phenomenon is associated with a small mobility of the heart and the movement of the diaphragm when the position of the body changes.

The right border of the heart is formed from above by the superior vena cava and from below by the right atrium. Its left border is formed from above by the left part of the aortic arch, the pulmonary trunk, the left auricle eye and the left ventricle. The front surface forms the right ventricle, the posterior one - the left ventricle. The heart as an organ that does not contain air gives a dull sound when percussion. On the sides it is partially covered with light, due to which relative or absolute dullness is determined. Relative dullness of the heart corresponds to its present boundaries and is the projection of the anterior surface on the chest, while the absolute - defines only the front surface, which is not covered by the lungs.

Percussion of the heart. Definition of absolute stupidity

The percussion sound over the area of relative dullness is quieter than over the absolute section. The latter is determined by quiet percussion of the heart. Normally, the right border of absolute cardiac dullness coincides with the left edge of the sternum in the section from IV to VI of the rib, the upper one with the lower edge of cartilage IV of the left rib to the left anterior line. The left border is defined in the fifth intercostal space by 10-15 mm to the right of the left sredneklyuchichnoy line.

The increase in absolute stupidity is observed with right ventricular hypertrophy, which is observed as a result of mitral stenosis, pulmonary embolism, exudative pericarditis. With emphysema, a decrease or even a complete absence of an area of absolute dullness is determined.

Percussion of the heart to determine relative stupidity

Relative cardiac dullness is determined as follows. First, the upper edge of the hepatic dullness is found, then, rising up two ribs upwards, percussion in the fifth intercostal space, toward the sternum until a dull sound appears, which corresponds to the location of the right border of the heart. Normally, it is located along the right edge of the sternum or 5-10 mm to the right of it. Then find the upper limit. For this, percussion from the left collarbone from the top down along the priruginnaya line. On the third rib, a dull percussion sound is normally heard, which corresponds to the location of the upper border of the heart. To determine the left margin, perculate in the fifth intercostal space, in the direction from the anterior axillary line to the sternum until a blunted sound appears. Normally the left border is in the fifth intercostal space by 10-15 mm to the right of the left sredneklyuchichnoy line.

In some diseases, the size of the heart can increase. For example, in hypertensive disease, aortic valve defects, the left border moves to the left, with myocarditis dilates all the heart cavities, and its boundaries shift to the left and to the right.

Percussion is also used for examination of organs located in the abdominal cavity, although it is less informative in this case than palpation. Percussion of the abdomen is mainly used to determine the boundaries of individual organs, that is, the topographic form of this study is applied.

Since the intestine always contains a sufficient amount of air, a high percussion sound is determined above the abdominal cavity. Percussion of the spleen, liver, kidneys gives a dull sound. These characteristics of sound can accurately determine the location, topographical placement of the abdominal organs.