Percussion helps you assess the amount and distribution of gas in the abdomen, viscera and masses that are solid or fluid-filled, and the size of the liver and spleen.

Percuss the abdomen lightly in all four quadrants to determine the distribution of tympany and dullness. Tympany usually predominates because of gas in the GI tract, but scattered areas of dullness from fluid and feces are also common.

■ Note any dull areas suggesting an underlying mass or enlarged organ. This observation will guide subsequent palpation.

■ On each side of a protuberant abdomen, note where abdominal tympany changes to the dullness of solid posterior structures.

■ Briefly percuss the lower anterior chest above the costal margins. On the right, you will usually find the dullness of the liver; on the left, the tympany that overlies the gastric air bubble and the splenic flexure of the colon.

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