During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with:
A. COPD
B. Pneumothorax
C. A normal finding
D. Pleural effusion
ANS: C
The lung fields should be percussed posteriorly, starting from the superior-most areas and then proceeding inferiorly to the level of the diaphragm. Resonance is the normal sound on percussion. Hyperresonance suggests air trapping, which occurs with COPD or tension pneumothorax. Dullness to percussion is detected over the actual site of consolidated lung or pleural fluid. Dullness is also found with pneumonia, severe atelectasis, or pleural effusion.
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