Respiratory examination

Components

1- General Ex

2- Inspection: from front and back

3-Palpation

4-Percussion

5-Auscultation

General respiratory Ex

We will cover these points : 1- general look2- vital signs 3- both hands4- eyes5- nose6- mouth7- sinuses8- neck9- Lower limb edema

General look

• Consciousness• Oriented• Distressed• Lying flat• Audible wheezing or stridor• Connected to IV line or O2 mask• Lip pursing• Acting nasal alae• Using accessory muscle

A : apperance

B : body built

C : color

D : distressed

E : environment

Hands

1- NailClubbing, cyanosis, nicotine staining2-palmWarm, pallor3-DorsumMuscle wasting4-TremorFine, flapping

5- Eyes

Pallor, jaundice, sign of Horner syndrome

6- Nose

Acting nasal alae

7- Mouth

Central cyanosis in the tip of the tongue

Peripheral cyanosis in lip or fingers

Lip pursing

8- Sinuses

9- Neck

JVP

Using accessory muscle

LN

Chest

By inspection

Type of breathing, symmetry, scar, deformity like .

Pectus excavatum, pectus carinatum, barrel chest, Harrison sulcus

Prominent veins, intercostals retraction

back, kyphosclosis

Pectus excavatum

pectus carinatum

By palpation

Tactile vocal fremitus

Chest expansion

Tracheal tug

Tracheal deviation

Apex beat

By percussion

( Resonant – Dull

-Hyperresonant)

? Symmetrical?

By auscultation

1- Air entry ( Breathing sounds)

2- Type of breathing

3- Added sounds like wheezing and fine or coarse crepitations or pleural friction rub

4- Vocal resonance

•Thank you