Where on the patient's back should hands be placed for assessing respiratory excursion?

To assess respiratory excursion effectively, the correct placement of the hands is around the 10th rib, with the thumbs positioned about 2 inches apart. This location is optimal because it allows for the evaluation of movement in the lower lobes of the lungs during inhalation and exhalation. By placing the hands at this level, the examiner can feel for the symmetrical expansion and contraction of the chest wall as the patient breathes.

This technique is particularly important for gauging the functionality of the diaphragm and assessing overall lung capacity. It ensures that the clinician can observe not only the rhythm of breathing but also any abnormalities or asymmetries in this crucial aspect of respiratory physiology.

Other anatomical locations, such as the area between the shoulder blades, the lower back near the iliac crest, or just below the neck, are not as effective for this specific assessment. These regions do not provide a comprehensive view of the thoracic expansion relevant to respiratory function, hence they fall short when assessing respiratory excursion directly.