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Diaphragmatic Excursion

By: Laurie Pomella. Diaphragmatic Excursion. 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

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Diaphragmatic Excursion

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  1. By: Laurie Pomella Diaphragmatic Excursion

  2. 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 independently • State the significance of an abnormal measurement

  3. 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).

  4. 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 breathe

  5. 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 breathe • Repeat on the other side • Measure and record the distance in centimeters between the marks

  6. Video Demonstration • http://youtu.be/8MHCE_h9QcM

  7. 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 left

  8. Abnormalities • Abnormally high level of dullness and absence of excursion indicate pleural effusion or atelectasis • Other causes include abdominal or superficial pain

  9. References Jarvis, C. (2008). Thorax and lungs. In R. Carter & D. Davis (Eds.), Physical examination & health assessment (5th 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 (7th ed., pp. 332-377). St. Louis, MI: Mosby.

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