What is stony dullness?

What does stony dullness indicate?

Dullness: suggests increased tissue density (e.g. cardiac dullness, consolidation, tumour, lobar collapse). Stony dullness: typically caused by an underlying pleural effusion. Hyper-resonance: the opposite of dullness, suggestive of decreased tissue density (e.g. pneumothorax).

What causes Stony dull percussion sound?

Dull or thudlike sounds are normally heard over dense areas such as the heart or liver. Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such as occurs with pneumonia, pleural effusions, or tumors.

What causes dull percussion?

Dullness is typically considered an abnormal sound if elicited with percussion over the lungs or the intestines, stomach, or bladder. In this case, it could represent intestines that are filled with stool, indicating constipation, a bowel obstruction, or some sort of mass.

What causes Hyperresonant percussion?

If the percussion produces a drum-like sound known as hyperresonance, it could indicate air has filled the space around your lungs and is prohibiting them from expanding fully. It may also suggest that air is trapped inside the small airways and alveoli (air sacs) of your lungs.

What does Hyperresonant mean?

Medical Definition of hyperresonance : an exaggerated chest resonance heard in various abnormal pulmonary conditions.

What are the 5 percussion tones?

There are five common terms used to describe percussion notes in the physical examination: tympanitic, hyperresonant, resonant, dull, and flat.

What do lung sounds sound like with pneumonia?

Crackling or bubbling noises (rales) made by movement of fluid in the tiny air sacs of the lung. Dull thuds heard when the chest is tapped (percussion dullness), which indicate that there is fluid in a lung or collapse of part of a lung.

What is percussion tenderness?

Tenderness on percussion is abnormal and can indicate peritoneal inflammation. After abdominal area, percuss the lower anterior chest, above the costal margins. Dull sound on the right, over the liver is expected... On the left, one should hear tympany over the gastric air bubble and the splenic flexure of the colon...

What is blunt percussion used for?

(Another blunt percussion method, used in the neurologic examination, involves tapping a rubber-tipped reflex hammer against a tendon to create a reflexive muscle contraction.) Percussion produces sounds that vary according to the tissue being percussed.

What is fremitus in lung sounds?

Vocal fremitus is a vibration transmitted through the body. It refers to the assessment of the lungs by either the vibration intensity felt on the chest wall (tactile fremitus) and/or heard by a stethoscope on the chest wall with certain spoken words (vocal resonance).

What are the sounds of lungs which indicate the percussion?

Percussion produces sounds on a spectrum from flat to dull depending on the density of the underlying tissue. Areas of well-aerated lung will be resonant, or tympanic, to percussion. Dullness to percussion indicates denser tissue, such as zones of effusion or consolidation.

What is the difference between a pneumothorax and a pleural effusion?

Pleural effusion - excess fluid in the pleural space. Pneumothorax - buildup of air or gas in the pleural space.

What does percussion of the abdomen tell you?

Percussion of the abdomen involves tapping the body to elicit sounds and determining whether the sounds are appropriate for the underlying structure of the quadrant. This provides information about the overall consistency of the abdomen as well as the size and borders of some of the underlying structures.

What causes tracheal deviation during tension pneumothorax?

Pneumothorax is the most frequently reported cause of tracheal deviation from pressure buildup. This condition happens when excess air builds up in your chest cavity and can't escape. It's also known as a collapsed lung. The growth of cancerous tumors, lymph nodes, and glands can also create pressure in your chest.

What is dullness and tympany?

Tympany versus dullnessTympany is typically heard over air-filled structures such as the small intestine and the large intestine. Dullness is typically heard over fluid or solid organs such as the liver or spleen, which can be used to determine the margins of the liver and spleen.

What is the difference between resonant and tympanic?

Tympanitic, drum-like sounds heard over air filled structures during the abdominal examination. Hyperresonant (pneumothorax), said to sound similar to percussion of puffed up cheeks. Normal resonance/ Resonant, the sound produced by percussing a normal chest.

What does shifting dullness indicate?

Shifting dullness and fluid thrill (wave) are clinical signs that confirm ascites. Free fluid will flow to the dependent part of the abdominal cavity, while the gut filled with air will float in the middle. If the child is supine, the fluid collects posteriorly and in the flanks.

What is rebound and guarding?

Guarding can often be overcome by having the patient purposely relax the muscles; rigidity cannot be. Rigidity is thus a clear-cut sign of peritoneal inflammation. Rebound tenderness is the elicitation of tenderness by rapidly removing the examining hand.

What is the difference between guarding and rigidity?

Guarding - refers to a voluntary muscle contraction, to protect from pain. Rigidity - refers to an involuntary muscle spasm due to underlying inflammation.

What does McBurney's point mean?

McBurney point corresponds to the location of the base of the appendix and is found by placing the little finger of one hand in the umbilicus and the thumb on the anterior superior ileal spine.

What is pneumonia Covid?

COVID-19 Pneumonia In pneumonia, the lungs become filled with fluid and inflamed, leading to breathing difficulties. For some people, breathing problems can become severe enough to require treatment at the hospital with oxygen or even a ventilator. The pneumonia that COVID-19 causes tends to take hold in both lungs.

What is tactile fremitus?

Tactile fremitus, also known as tactile vocal fremitus, refers to the vibration of the chest wall that results from sound vibrations created by speech or other vocal sounds.

What is dullness mean?

dullness noun [U] (LACK OF INTEREST)the fact of not being interesting or exciting, or of not being interested in anything: She managed to get exquisite material out of the dullness of her home town.

What is the difference between crackles and wheezes?

Crackles occur if the small air sacs in the lungs fill with fluid and there's any air movement in the sacs, such as when you're breathing. The air sacs fill with fluid when a person has pneumonia or heart failure. Wheezing occurs when the bronchial tubes become inflamed and narrowed.

What does fremitus mean?

Definition of fremitus : a sensation felt by a hand placed on a part of the body (such as the chest) that vibrates during speech.

What should you hear when Percussing the abdomen?

The anterior gas-filled abdomen normally has a tympanitic sound to percussion, which is replaced by dullness where solid viscera, fluid, or stool predominate. The flanks are duller as posterior solid structures predominate, and the right upper quadrant is somewhat duller over the liver.

Should abdomen be firm or soft?

Normal: Abdomen is soft, rectus muscle is relaxed and no discomfort is elicited during palpation.

What is difference between pneumothorax and tension pneumothorax?

Pneumothorax is when air collects in between the parietal and viscera pleurae resulting in lung collapse. It can happen secondary to trauma (traumatic pneumothorax). When mediastinal shifts accompany it, it is called a tension pneumothorax. This is a life-threatening emergency that needs urgent management.

How can you distinguish between tension pneumothorax and cardiac tamponade?

Pearl of wisdom: Only cardiac tamponade and tension pneumothorax produce jugular venous distention with a chest injury. How you tell the difference is by auscultating the lungs. Tamponade will typically reveal clear, bilateral, lung sounds while a tension pneumothorax will not.

What is the difference between open pneumothorax and tension pneumothorax?

Tension pneumothorax develops when air continuously enters the chest without evacuation. The pleural pressure can reach supraatmospheric levels and can be life-threatening. In open pneumothorax, sealing of the chest must occur, followed by evaluation of air.

Is pleural effusion and pneumonia the same thing?

Pleural effusion is a buildup of fluid in the pleural space. The pleural space is the area between the layers of the tissue lining the lung and the chest cavity. In a person with parapneumonic pleural effusion, the fluid buildup is caused by pneumonia.

What is the most common cause of a pleural effusion?

There are two types of pleural effusion: Transudative pleural effusion is caused by fluid leaking into the pleural space. This is from increased pressure in the blood vessels or a low blood protein count. Heart failure is the most common cause.

What kind of infection causes pleural effusion?

Infections. Some illnesses that lead to pleural effusion are pneumonia or tuberculosis. Autoimmune conditions. Lupus or rheumatoid arthritis are some diseases that can cause it.

What is the difference between Rhonchi and crackles?

This is a fine, high-pitched crackling or rattling sound that can occur when you inhale. Rhonchi. This is a low-pitched sound that resembles snoring.

What type of lung sounds are heard with COPD?

Coarse crackles heard at the beginning of inspiration are commonly heard in patients with COPD, especially those with chronic bronchitis. These crackles have a “popping-like” character, vary in number and timing and may be heard over any lung region.

What are coarse lung sounds?

Rhonchi are coarse, loud sounds caused by constricted larger airways, including the tracheobronchial passages. These sounds occur during expiration, or both inspiration and expiration, but they do not occur in inspiration alone.

What is normal fremitus?

A normal evaluation occurs when equal and moderate vibrations are noticed during speech. Fremitus is abnormal when it is increased or decreased. Because sound is transmitted more strongly through non–air-filled lung, increased fremitus suggests a loss or decrease in ventilation in the underlying lung.

What does increased fremitus mean?

An increase in tactile fremitus indicates denser or inflamed lung tissue, which can be caused by diseases such as pneumonia. A decrease suggests air or fluid in the pleural spaces or a decrease in lung tissue density, which can be caused by diseases such as chronic obstructive pulmonary disease or asthma.

What is the first line treatment for pneumonia?

Pneumonia should be treated with antibiotics. The antibiotic of choice for first line treatment is amoxicillin dispersible tablets. Most cases of pneumonia require oral antibiotics, which are often prescribed at a health centre.

What is the best drug to treat pneumonia?

The first-line treatment for pneumonia in adults is macrolide antibiotics, like azithromycin or erythromycin. In children, the first-line treatment for bacterial pneumonia is typically amoxicillin.

What is Lanz incision?

The Lanz and Gridiron incisions are two incisions that can be used to access the appendix, predominantly for appendicetomy. Both incisions are made at McBurney's point (two-thirds from the umbilicus to the anterior superior iliac spine).

What is pinch an inch test?

Our pinch-an-inch test is essentially a form of rebound tenderness, only in reverse. To perform the test, a fold of abdominal skin over McBurney's point is grasped and elevated away from the peritoneum (see Fig. 1). The skin is then allowed to recoil back briskly against the peritoneum.

What is rebound tenderness?

Rebound tenderness, also known as Blumberg's sign, refers to the presence of pain when pressure is removed from the abdomen, rather than when applied. Although rebound tenderness can be elicited when performing Rovsing's sign, it is not the same thing.

What causes guarding?

Another term for this protective mechanism is guarding. This symptom isn't the same as intentionally flexing your abdominal muscles or the rigidity associated with severe gas. Guarding is an involuntary response of the muscles. Guarding is a sign that your body is trying to protect itself from pain.

What is rebound tenderness like?

To check for rebound tenderness, a doctor applies pressure to an area of your abdomen using their hands. They quickly remove their hands and ask if you feel any pain when the skin and tissue that was pushed down moves back into place. If you do feel pain or discomfort, you have rebound tenderness.

What does guarding feel like?

Guarding is the voluntary or involuntary tensing of the abdominal muscles, and tends to be generalized over the entire abdomen. Voluntary guarding is a conscious contraction of the abdominal wall in anticipation of an exam that will cause pain.

Is guarding voluntary or involuntary?

GUARDING: Musculoskeletal rigidity is involuntary guarding, a condition of the musculature itself in response to peritonitis; voluntary guarding is when a patient grabs your hand to keep you from touching him or her out of fear you'll cause pain.

What causes rebound tenderness?

Rebound tenderness occurs when the tissue that lines the abdominal cavity (the peritoneum) is irritated, inflamed, or infected. This is called peritonitis.

What is tympanic percussion sounds?

Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally heard over the stomach, but is not a normal chest sound. Tympanic sounds heard over the chest indicate excessive air in the chest, such as may occur with pneumothorax.

What is a fluid thrill?

In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap.

How can you tell the difference between fat and ascites?

Ascites and fat move and feel different. A doctor may examine a person's abdomen when lying down and standing. The shape of the abdomen may suggest that it contains fluid rather than fat. A person with ascites may also have a distended abdomen, which is hard and swollen.

What does dullness on percussion mean?

Dullness is the normal sound heard when percussing tissues that are dense in consistency, such as the liver. Dullness is typically considered an abnormal sound if elicited with percussion over the lungs or the intestines, stomach, or bladder.

What are the 5 percussion tones?

There are five common terms used to describe percussion notes in the physical examination: tympanitic, hyperresonant, resonant, dull, and flat.

What is Hyperresonance sound?

If the percussion produces a drum-like sound known as hyperresonance, it could indicate air has filled the space around your lungs and is prohibiting them from expanding fully. It may also suggest that air is trapped inside the small airways and alveoli (air sacs) of your lungs.

What is the difference between resonant and tympanic?

Tympanitic, drum-like sounds heard over air filled structures during the abdominal examination. Hyperresonant (pneumothorax), said to sound similar to percussion of puffed up cheeks. Normal resonance/ Resonant, the sound produced by percussing a normal chest.

What is flatness on percussion?

Flatness is a soft, short tone heard when percussing over solid tissue like muscle and bone. Resonance is a low-pitched, hollow tone heard when percussing air-filled tissue like the lungs.

What does barrel chest indicate?

Barrel chest is a visible symptom of COPD, emphysema, osteoarthritis, and CF. The lungs fill with air and are unable to fully breathe out. This gives the chest a pronounced barrel shape. The treatment of barrel chest focuses on managing symptoms of the underlying condition and limiting the extent of lung damage.

What is the difference between tactile and vocal fremitus?

Vocal fremitus is a vibration transmitted through the body. It refers to the assessment of the lungs by either the vibration intensity felt on the chest wall (tactile fremitus) and/or heard by a stethoscope on the chest wall with certain spoken words (vocal resonance).

What are the 4 types of palpation?

Here's how to do the basic four techniques Palpation and percussion can alter bowel sounds, so you'd inspect, auscultate, percuss, then palpate an abdomen.

What is the Plexor finger?

In indirect percussion, the plexor finger strikes a pleximeter, which is typically the middle finger of the non-dominant hand placed against the patient's body. As the examiner's finger strikes the pleximeter (or directly against the surface of the patient's body), sound waves are generated.

What is Covid pneumonia?

COVID-19 Pneumonia In pneumonia, the lungs become filled with fluid and inflamed, leading to breathing difficulties. For some people, breathing problems can become severe enough to require treatment at the hospital with oxygen or even a ventilator. The pneumonia that COVID-19 causes tends to take hold in both lungs.

How do you get pneumonia from Covid?

COVID-19 can cause severe inflammation in your lungs. It damages the cells and tissue that line the air sacs in your lungs. These sacs are where the oxygen you breathe is processed and delivered to your blood. The damage causes tissue to break off and clog your lungs.