Surgery – Diagnostic testing – Sensitivity to impact
Reexamination Certificate
2002-09-05
2004-09-14
Winakur, Eric F. (Department: 3736)
Surgery
Diagnostic testing
Sensitivity to impact
Reexamination Certificate
active
06790184
ABSTRACT:
BACKGROUND
The percussion examination is an integral portion of every general physical exam of the thorax and many specialty exams including the pulmonary exam and the abdominal exam. The percussion exam is used to identify a variety of normal anatomical landmarks and to identify pathological conditions such as ascites, pulmonary infiltrates, and organomegally. The standard percussion exam is performed by placing one hand with spread fingers on the patient. One finger of the other hand is used to strike one finger of the hand on the patient in a brisk swinging motion. The resulting tapping action results in an audible sound which may be characterized as “tympanic”, “resonant”, “dull”, or a variety of other variations. These sounds are then used to identify the boundaries of organs or the presence of abnormalities.
The sound heard from the standard method of percussion is often very faint and therefore very difficult to interpret. In addition to being difficult to hear, the quality may be affected by the characteristics of the examiner's fingers themselves and the examiner's personal exam technique. The standard exam consists of multiple taps on the patient used for point to point comparison of the changes in sound at different places on the patient. Therefore, variations in the technique from one tap to another or one physician to another may affect the results of the exam.
SUMMARY
A small device clips onto the end of a stethoscope and aids during the percussion portion of a physical exam of the thorax or abdomen. The device is essentially a small mechanical “tapper” which is operated by pressing a small plunger with the index finger of the hand holding the end of the stethoscope onto the patient's body. During a normal percussion exam, the physician taps on the abdomen or thorax with a finger from one hand hitting a finger of the other hand placed on the body. The very faint sounds heard from this action can be classified as “tympanic, dull, resonant, etc” and help to diagnose organomegaly, ascities, lung infiltrates and other anatomy and abnormalities. This device aids in the exam by amplifying the percussion sounds heard because it is used together with the stethoscope. It also allows for one hand operation so this exam can be easily combined with the auscultation portion of the regular physical exam.
In some embodiments, the device includes a base adapted to be clipped to the head of the stethoscope with a hammer support extending over a patient, and a hammer supported by the hammer support and actuated by a user to tap on the patient. The hammer may include a finger pad that is depressed by the user to actuate the hammer, and a flared piston head piece that taps on the patient when the user depresses the finger pad. The finger pad and the head piece can be made from stainless steel. In certain embodiments, the hammer includes a main piston body positioned within a casing that is supported by the hammer support. The casing may be made from stainless steel, while the piston body may be made from brass.
Some embodiments can have a spring positioned around at least a portion of the main piston body and within the casing. In such embodiments, the spring acts to return the hammer to its starting position after being actuated by the user. The spring can be a stainless steel compression spring. The base can be secured to the head of the stethoscope with a set-screw.
Some embodiments may have one or more of the following advantages. The device greatly improves acoustics due to its design and use in conjunction with the stethoscope. In addition, the device allows for a one-hand percussion examination which will allow the healthcare professional to use the other hand for other purposes and to access portions of the body which may be more difficult to reach with two hands. This device conveniently attaches to the stethoscope and therefore is easy to carry and use. The spring-loaded piston provides a regular tapping action and may allow for a more astute diagnose of differences in the acoustic response from one point to another on the patient.
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Hamilton Brook Smith & Reynolds P.C.
Sure-Shot Medical Device, Inc.
Szmal Brian
Winakur Eric F.
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