Diaphragmatic Excursion
(normally 3cm to 5 cm).

  • a) Patient seated takes a deep breath and holds it.
  • b) Percuss the back downward until a definite change in the PER note is found. Indicates the lower level of diaphragmatic excursion.
  • c) Repeat step b with the Patient holding his/her breath in full expiration (breath out as much as possible). Indicates the upper level of diaphragmatic excursion.
  • d) The Diaphragmatic excursion is the distance between the two levels.

    High diaphragm: Pregnancy, ascites, increased intra-abdominal pressure.
    Low/fixed diaphragm: Emphysema.