By Laurie Pomella Objectives At the conclusion of this presentation the viewer will be able to State the rationale for performing diaphragmatic excursion State the steps for performing a diaphragmatic excursion measurement ID: 264345
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Slide1
Diaphragmatic Excursion
By: Laurie PomellaSlide2
Objectives
At the conclusion of this presentation the viewer will be able to:
State the rationale for performing diaphragmatic excursion
State the steps for performing a diaphragmatic excursion measurement
Measure diaphragmatic excursion independentlyState the significance of an abnormal measurementSlide3
Purpose
“A simple measurement of diaphragmatic excursion is therefore a valuable clinical index of pulmonary compliance and another diagnostic point in the differential diagnosis of dyspnea and diffuse pulmonary disease” (Milne & Bass, 1969, excerpt summary). Slide4
Technique
Ask the patient to take a deep breath and hold their breath in
Percuss along the scapular line until you locate the lower
scapular boarder
Mark this point and allow patient to breatheSlide5
Technique Continued
Ask the patient to exhale and hold the breath out
Percuss up from the previous mark and locate the lower
scapular boarder
Mark this point and allow patient to breatheRepeat on the other side
Measure and record the distance in centimeters between the marksSlide6
Video Demonstration
http://youtu.be/8MHCE_h9QcMSlide7
Findings
The diaphragmatic excursion should be equal bilaterally
Normal measurement is about 3 to 5 cm in adults
The diaphragm is usually higher on the right than on the leftSlide8
Abnormalities
Abnormally high level of dullness and absence of excursion indicate pleural effusion or atelectasis
Other causes include abdominal or superficial painSlide9
References
Jarvis, C. (2008). Thorax and lungs. In R. Carter & D. Davis (Eds.),
Physical examination & health assessment
(5
th ed., pp. 437-480). St. Louis, MI: Saunders. Mdofola (Producer). (September, 2010). Diaphragm excursion
[Video file]. Retrieved from http://youtu.be/8MHCE_h9QcM
Milne, E.N. & Bass, H. (March, 1969). Relationship between specific dynamic pulmonary compliance and diaphragmatic excursion.
Radiology, 92
, 615. doi: 10.1148/92.3.615
Seidel, H.M., Ball, J.W.,
Dains
, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2011). Chest and lungs. In R. Carter & D.
Dedeke
(Eds.),
Mosby’s guide to physical examination
(7
th
ed., pp. 332-377). St. Louis, MI: Mosby.