Percussion

Percuss the anterior and lateral chest, again comparing both sides. The heart Dullness replaces resonance normally produces an area of dullness to the left of the sternum from the 3rd when fluid or solid tissue replaces to the 5th interspaces. Percuss the left lung lateral to it. air-containing lung or occupies the pleural space. Because pleural fluid usually sinks to the lowest part of the pleural space (posteriorly in a supine patient), only a very large effusion can be detected anteriorly.

The hyperresonance of COPD may totally replace cardiac dullness.

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