Evaluate Diaphragmatic Movement

Percussion is also used to detect diaphragmatic movement. The patient is asked to take a deep breath and hold it. Percussion at the right lung base helps determine the lowest area of resonance, which represents the lowest level of the diaphragm. Below this level is dullness from the liver. The patient is then instructed to exhale as much as possible, and the percussion is repeated. With expiration, the lung contracts, the liver moves up, and the same area becomes dull; that is, the level of dullness moves upward. The difference between the inspiration and expiration levels represents diaphragmatic motion, which is normally 4 to 5 cm. In patients

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