For the D sharp in the 4th octave, press down your Left Thumb on the B Key, Index Finger, Middle Finger, Ring Finger,  and Pinkey Finger. In your Right Hand press down your Index Finger, Middle Finger, Ring Finger, place your pinkey on the E Flat Key<p><a href="modern.html#contentstart">Back to the Accessible Fingering Chart</a></p>