Percussion

Question 1

Left Anterior Apical Segment

Answer 1

Laying in semi-fowler position (~45deg with feet elevated)

• same side technique
• stand in front of patient
• percuss above the clavicle anteriorly

Question 2

Right/Left Posterior Apical Segment

Answer 2

Seated upright in long sit

• same side technique
• stand in front of patient
• percuss on upper traps

Question 3

Right/Left Anterior Upper Lobe

Answer 3

Laying supine

• CROSS BODY TECHNIQUE
• percuss just below clavicle from humerus to sternum

Question 4

Right Posterior Upper Lobe

Answer 4

Lie on left side 3/4 turned from prone (pillow under arm to get the scapula out of the way)

• same side technique
• face patient
• percuss right above the spine of the scapula towards the SPs

Question 5

Left Posterior Upper Lobe

Answer 5

Lie on right side 3/4 turned from prone (pillow under arm to get the scapula out of the way) HEAD RAISED 45DEG

• same side technique
• face patient
• percuss right above spine of the scapula towards the SPs

Question 6

Right/Left Lingular Segments

Answer 6

S/L so treating side is up, quarter turn upper body post FEET 12” HIGHER THAN HEAD

• stand on the side the patient is lying (cross table)
• percuss 4-6th rib from sternum to MCL (pledge area)

Question 7

Right/Left Anterior Lower Lobe

Basalar Segments

Answer 7

Lays supine, LEGS 18-20” HIGHER THAN HEAD

• cross body technique
• percuss 4-6th ribs from AAL to sternum (just under breast)

Question 8

Right/Left Posterior Lower Lobe

Answer 8

Lays prone, LEGS 18-20” HIGHER THAN HEAD

• same side technique, pts head turned to you
• percuss 4-8th rib in between scap and SPs

Question 9

Right/Left Anterior Lateral Lower Lobe

Answer 9

Lays on side so treating lung is up, pillow under waist so the spine is straight, pillow under arm to get scapula out of the way. FEET 18-20” HIGHER THAN HEAD

• same side technique BOTH HANDS
• percuss inferior border of scapula - 8th rib
• AAL to PAL

Question 10

Right/Left Posterior Lateral Lower Lobe

Answer 10

Lie on side so treating lung is up, LEGS 18-20” HIGHER THAN HEAD

• same side technique BOTH HANDS
• percuss MAL under scap to the SPs

Question 11

Right/Left Superior Lower Lobe

Answer 11

Lay prone, pillow under abdomen to flatten back

• same side technique BOTH HANDS
• pts head is facing the way you are standing
• percuss from inferior angle of scapula, 10th rib, PAL to SPs

Question 12

Modified Position - if pt is vented

Answer 12

S/L with treating side up

• same side technique BOTH HANDS
• percuss C7-T10 (not on scap) AAL to SPs
• 20 mins, make sure you listen to vent

Question 13

VIBRATION

done if pt cannot be percussed

Answer 13

osteoporosis, fx, etc

• co-contraction of UE over thorax during exhalation
• done for 3 breaths
• quick stretch after each exhalation

*if pt was not percussed, do for 5 min during exhalation