Nursing Student question

aCRNAhopeful · Oct 10, 2008

I believe it's dullness. I'm pretty sure hyperresonance is heard over areas of air trapping which would make me think resonance is heard over normal lung fields. On second thought atelectasis and air trapping (like with COPD) kind of go hand-in-hand so I'm not sure. Does anyone really go around tapping on patients chest these days anyways???

Jilaweez, BSN, MSN, RN · Oct 10, 2008

I would probably choose A, it would percuss as dullness. Resonance would be heard over normal lung tissue.

GOMER42 · Oct 10, 2008

On second thought atelectasis and air trapping (like with COPD) kind of go hand-in-hand

Atelectasis involves the collapse of alveoli, air trapping involves the hyperinflation of alveoli-- they are in opposition, not hand in hand

aCRNAhopeful · Oct 11, 2008

They are in opposition but both occur with COPD. Hyperinflated alveoli cannot get air out and will then collapse under the positive pressure that occurs with expiration. Thats why maintaining positive pressure with pursed lip breathing or CPAP of something like that prevents air trapping and atelectasis.

Daytonite, BSN, RN · Oct 11, 2008

welcome to allnurses. you will find student forums and lots of help from fellow students if you post on these two threads:

https://allnurses.com/forums/f205/ - nursing student assistance forum
https://allnurses.com/forums/f50/ - the general nursing student discussion forum

percussion over an area of atelectasis in the lungs would reveal:

a) dullness

b) tympany

c) resonance

d) hyperresonance

"dullness over the lungs during percussion, possibly indicating a mass or consolidation." (page 148, mosby's expert 10-minute physical examinations by cindy tryniszewski (editor), 2nd edition, 2004). "dullness detected on percussion, for example, may represent either lung consolidation or a pleural effusion." (the lung exam, http://meded.ucsd.edu/clinicalmed/introduction.htm)

tympany is "a high-pitched, drum-like sound. . .usually heard over the stomach". (page 15, mosby's expert 10-minute physical examinations by cindy tryniszewski (editor), 2nd edition, 2004). it is due to the presence of gas.

resonance is a "low-pitched, hollow sound. . .usually heard over normal lung tissue". (page 15, mosby's expert 10-minute physical examinations by cindy tryniszewski (editor), 2nd edition, 2004) atelectasis is not normal and is a pathologic finding. "the absence of resonance is termed flatness; diminished resonance, dullness" (page 1661, taber's cyclopedic medical dictionary, 18th edition).

hyperresonance is "a loud, booming sound. . .usually heard over a hyperinflated lung, as in patients with emphysema." (page 15, mosby's expert 10-minute physical examinations by cindy tryniszewski (editor), 2nd edition, 2004)

there is a sticky thread on the nursing student assistance forum with weblinks to information on physical assessment:

https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms