Chest Expansion Measurements

Question 1

What is the purpose of this technique? What are you measuring? Why?

Answer 1

Can be used as a wider assessment to explore causes for:
- breathlessness
- reduced exercise tolerance
- abnormal lung functions test
… found in a wide range of pathologies

You are measuring the change of chest circumference between full inspiration and full expiration.

Question 2

How do you know whether the measurement is normal?

Answer 2

Compare it against normal averages or previous healthy tests

Question 3

What are the principles used in carrying out the technique?

Answer 3

Identification of correct bony landmarks:
To get accurate starting point.

Accuracy of use of measurement tools:
Tape should be parallel anteriorly and posteriorly. Not twisted. Lying flat. Place visible mark to indicate tape position.

Standardising start positions:
Improve repeatability

Question 4

What structures/processes are being assessed?

Answer 4

?

Question 5

Contraindications

Answer 5

Disorders affecting test performance e.g.:
Vomiting
Nausea
Vertigo

Unstable cardiac conditions

Thoracic trauma

Question 6

Precautions

Answer 6

Things that may affect patient comfort such as tissue damage/wounds for example.

Question 7

How would you take an Apical measurement?

Answer 7

1. Patient topless, sat up.
2. Place tape around chest wall online with axilla
3. Ask patient to breathe out, take measurement on full expiration.
4. Holding tape in position, ask the patient to breathe in as much as they can to fill inspiration. Take the measurement.
5. Calculate the difference
6. Repeat until you have three measurements.
7. Document the largest measure.
8. Ask patient for any adverse effects.

Question 8

How would you take basal measurements?

Answer 8

1. Patient topless, sat up.
2. Place tape around chest wall in line with xiphoid process of sternum. Ensure tape is not twisted and is parallel anteriorly and posteriorly.
3. Ask patient to breathe out, take measurement on full expiration.
4. Holding tape in position, ask the patient to breathe in as much as they can to fill inspiration. Take the measurement.
5. Calculate the difference
6. Repeat until you have three measurements.
7. Document the largest measure.
8. Ask patient for any adverse effects.