Respiratory Examination

The Respiratory Examination
1. Inspection
Surface anatomy
Cyanosis
Respiratory Rate and Character
Count the respiratory rate at rest
Inspection of the hands
--clubbing
--nicotine staining
--wasting and weakness
--flapping tremor
Inspection of the chest
--abnormal shape (barrel chest, pigeon chest and funnel chest).
--scars - evidence of previous chest operations or injury.
--asymmetry in the movement of the chest wall
--use of accessory muscles
3. Palpation
Feel the trachea
Palpate the cervical and supraclavicular nodes.
Measure chest expansion
Assess vocal fremitus
Percussion
To examine the lung apices, percuss the clavicles directly. Percuss the front of the chest,
moving the percussed finger down about 6-8 cm at a time. Identify the upper border of the liver,
which is usually at the level of the 5th intercostal space on the right.
When examining a patient, solid tissue sounds less resonant than air filled tissue. Fluid filled
tissue is said to sound “stony dull”.
4. Auscultation
Four aspects of auscultation of lung fields should be considered:
• Quality of Breath Sounds
• Intensity of Breath Sounds
• Added or Abnormal Breath Sounds
• Vocal Resonance

Very succint overview - expansion on given points to be found on week five study guide/workbook.

A reasonably good video tutorial for chest examination (includes respiratory and cardiac) can be found here (http://www.med-ed.virginia.edu/courses/pom1/videos/index.cfm) under 'vital signs and chest', and the 'chest examination'.
There are lots of audio/video files available for chest sounds. I listened to the one on oscetube.com.

Sam