Respiratory Physical Exam

Question 1

what is pulsus paradoxus

Answer 1

inspiratory reduction in BP more than 10 mmHg–related to tension pneumothorax and asthma

Question 2

what should you look for on inspection

Answer 2

breathlessness, WOB
cachexia
examin sputum if available

look at hands, neck, eyes, mouth, face, chest

Question 3

what to look for on resp exam in the hands

Answer 3

clubbing (CF, bronchiectasis, bronchogenic carcinoma)

nicotine staining

peripheral cyanosis

muscle wasting

tremor (from B2 agonists)

Question 4

what to look for on resp exam in the neck

Answer 4

examine JVP

increased in cor pulmonale and tension pneumo

Question 5

what to look for on resp exam in the eyes

Answer 5

anemia

Question 6

what to look for on resp exam in the mouth

Answer 6

central cyanosis

pursed lip breathing COPD

tonsils

hoarse voice

stridor

Question 7

what to look for on resp exam in the face

Answer 7

ptosis, miosis and anhydrosis suggestive of horners or SVC obstruction

Question 8

what to look for on resp exam in the best

Answer 8

accessory muscle use

intercostal indrawing

diaphragmatic parados

scars, drains, radiotherapy marks

tracheal deviation

kyphosis

scoliosis

lordosis

barrel chest

pectus excavatum

pectus carinatum

Question 9

what should you palpate for on resp exam

Answer 9

tracheal deviation

LAD

tactile fremitus

respiratory expansion

location of apex beat

Question 10

what should you check for on percussion

Answer 10

dullness–consolidation

hyperresonance–hyperinflation or PTX

diaphragmatic excursion–normal is 3-6 cm