Physical Findings Associated with Common Respiratory Conditions

Question 1

Asthma- Inspection

Answer 1

Tachypnea
Nasal Flaring
Intercostal Retractions

Question 2

Asthma- Palpation

Answer 2

Tachycardia

Diminished Fremitus

Question 3

Asthma-Percussion

Answer 3

Occasional hyperresonance
Occasional Limited:
-Diaphragmatic Descent
- Diaphragmatic Level Lower

Question 4

Asthma- Auscultation

Answer 4

Prolonged Expiration
Wheezes
Diminished Lung Sounds

Question 5

Atelectasis- Inspection

Answer 5

Delayed and/or diminished chest wall movement, narrowed intercostal spaces on affected side

Tachypnea

Question 6

Atelectasis- Palpation

Answer 6

Diminished fremitus
Apical cardiac impulse- deviated ipsilaterally
Trachea deviated ipsilaterally

Question 7

Atelectasis- Percussion

Answer 7

Dullness over affected lung

Question 8

Atelectasis- Auscultation

Answer 8

In upper lobe, bronchial breathing, egophony, whispered pectoriloquy

In lower lobe, diminished or absent breath sounds

Wheezes, rhonchi, and crackles in varying amounts depending on extent of collapse

Question 9

Bronchiectasis- Inspection

Answer 9

Tachypnea
Respiratory distress
hyperinflation
Clubbing

Question 10

Bronchiectasis- Palpation

Answer 10

Few, if any, consistent findings

Question 11

Bronchiectasis- Percussion

Answer 11

No unusual findings if there are no accompanying pulmonary disorders

Question 12

Bronchiectasis- Auscultation

Answer 12

A variety of crackles, usually coarse, and rhonchi, sometimes disappearing after cough

Question 13

Bronchitis- Inspection

Answer 13

Occasional tachypnea
Occasional shallow breathing
Often no deviation from expected findings

Question 14

Bronchitis- Palpation

Answer 14

Tactile Fremitus undiminished

Question 15

Bronchitis- Percussion

Answer 15

Resonance

Question 16

Bronchitis- Auscultation

Answer 16

Breath sounds may be prolonged.

Occasional crackles, expiratory wheezes and rhonci

Question 17

COPD- Inspection

Answer 17

Respiratory Distress
Audible wheezing
Cyanosis
Distention of neck veins, peripheral edema (in the presences of R-sided Heart failure)
Clubbing (rarely)

Question 18

COPD- Palpation

Answer 18

Somewhat limited mobility of diaphragm

Somewhat diminished vocal fremitus

Question 19

COPD- Percussion

Answer 19

Occasional hyperresonance

Question 20

COPD- Auscultation

Answer 20

Postpertussive rhonchi (sonorous wheezes) and sibilant wheezing

Inspirational crackles (best heard with stethoscope held over open mouth)

Breath sounds somewhat diminished

Question 21

Emphysema- Inspection

Answer 21

Tachypnea
Deep Breathing
Pursed lips 
Barrel Chest
Thin, underweight

Question 22

Emphysema- Palpation

Answer 22

Apical impulse may not be felt
Liver edge displaced downward
Diminished Fremitus

Question 23

Emphysema- Percussion

Answer 23

Hyperresonance
Limited descent of diaphragm on inspiration
Upper border of liver dullness pushed downward

Question 24

Emphysema- Auscultation

Answer 24

Diminished breath and voice sounds with occasional prolonged expiration

Diminished audibility of heart sounds

Only occasional adventitious sounds

Question 25

Pleural Effusion- Inspection

Answer 25

Diminished and delayed respiratory movement on affected side

Question 26

Pleural Effusion- Palpation

Answer 26

Cardiac apical impulse shifted contralaterally Trachea shifted contralaterally Diminished Fremitus Tachycardia

Question 27

Pleural Effusion- Percussion

Answer 27

Dullness to flatness | Hyperresonant note in area superior to effusion

Question 28

Pleural Effuision- Auscultation

Answer 28

Diminished to absent breath sounds Bronchophony, whispered pectoriloquy Egophony and/or crackles in area superior to effusion Occasional friction rub

Question 29

Pneumonia consolidation- Inspection

Answer 29

``` Tachypnea Shallow breathing Flaring of alae nasi Occasional cyanosis Limited movement at times on involved side; splinting ```

Question 30

Pneumonia Consolidation- Palpation

Answer 30

Increased fremitus in presence of consolidation Decreased fremitus in presence of a concomitant empyema or pleural effusion Tachypnea

Question 31

Pneumonia Consolidation- Percussion

Answer 31

Dullness if consolidation is great

Question 32

Pneumonia Consolidation- Auscultation

Answer 32

A variety of crackles with lobar and occasional rhonchi Bronchial Breath sounds Egophony, bronchophony, whispered pectoriloquy

Question 33

Pneumothorax- Inspection

Answer 33

Tachycardia Cyanosis Respiratory distress Bulging intercostal spaces Respiratory lag on affected side Tracheal deviation with tension pneumothorax

Question 34

Pneumothorax- Palpation

Answer 34

``` Diminished to absent fremitus Cardiac apical impulse. trachea, and mediastinum shifted contralaterally Diminished to absent tactile fremitus Tachycardia Subcutaneous crepitance from air leaking ```

Question 35

Pneumothorax- Percussion

Answer 35

Hyperresonance

Question 36

Pneumothorax- Auscultation

Answer 36

Diminished to absent breath sounds Succussion splash audible if air and fluid mix Diminished to absent breath sounds Sternal and precordial clicks and crackling (Hamman sign) if air underlies that area Diminished to absent whispered voice sounds