Percuss the Anterior Chest

Percussion of the anterior chest includes the supraclavicular fossae, the axillae, and the anterior interspaces, as illustrated in Figure 13-22. The percussion note on one side is always compared with that elicited in the corresponding position on the other side. Dullness may be noted in the third to fifth intercostal spaces to the left of the sternum, which is related to the presence of the heart. Percuss high in the axilla because the upper lobes are best evaluated at these positions. Axillary percussion is sometimes easier to perform while the patient is sitting.

Figure 13-21 Tracheal deviation. Note the marked tracheal deviation to the patient's right.

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