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Clinical Question To Im Resident Please


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Regarding percussion of the lungs......... I know I have to percuss in the inter-costal spaces not on the ribs.......but I have a problem in locating them.....no matter whether the patient is lean or obese.....I just don't know whether I am percussing on a rib or an intercostal space.....I can't feel whether there is a bone under my finger or not  :(


I have seen a lot of videos.........everybody seems to be doing it so gracefully......


Any tips from an IM resident is greatly appreciated.

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Explains a lot... Never taking any of your posts even remotely seriously again.


You talk about being IMG, then CMG, then matching in the best residency programmes of the USA and Canada as an IMG, then talk about getting in medicine at McGill and how to get Qc residency status lol....

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I'll answer, although not an IM resident yet, so take it with a grain of salt


Anteriorly, I usually roll my finger down from the clavicle and imagine the anatomy and approximate where the 2nd, 3rd, 4th ICS would be and percuss.

My finger is nice and juicy so typically it 'fits' nicely unto the intercostal space


Posteriorly, I do the same thing but it's kinda hard since there's the scapula blocking our way (Even if you get them to cross their arms), so I feel for the same 'fit'.



In the end, it all comes back to how much you practice. I practised a ton on myself and I'm lucky cuz i'm skinny.


P.S. you will rarely do this in practice, but instead just auscultate and order a radiograph 

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