(swelling or hardening of normally soft tissue) of a normally aerated lung. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts.The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery).Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation.Web Site Design by Jan Thompson, Program Representative, UCSD School of Medicine. D., UCSD School of Medicine and VA Medical Center, San Diego, California 92093-0611. Learning the appropriate techniques at this juncture will therefore enhance your ability to perform these other examinations as well. The 4 major components of the lung exam (inspection, palpation, percussion and auscultation) are also used to examine the heart and abdomen.Vital signs, an important source of information, are discussed elsewhere.Inspection/Observation: A great deal of information can be gathered from simply watching a patient breathe.Pay particular attention to: Percussion: This technique makes use of the fact that striking a surface which covers an air-filled structure (e.g.
If the normal, air-filled tissue has been displaced by fluid (e.g.pleural effusion) or infiltrated with white cells and bacteria (e.g.pneumonia), percussion will generate a deadened tone.Alternatively, processes that lead to chronic (e.g. pneumothorax) air trapping in the lung or pleural space, respectively, will produce hyper-resonant (i.e. Initially, you will find that this skill is a bit awkward to perform.Allow your hand to swing freely at the wrist, hammering your finger onto the target at the bottom of the down stroke.A stiff wrist forces you to push your finger into the target which will not elicit the correct sound.