Respiratory Exam

Question 1

Cardinal Symptoms

Answer 1

1. SoB
2. Chest pain
3. Cough, wheeze, sputum, haemoptysis
4. Hoarse voice
5. Sinusitis

Question 2

The correct position + adequate exposure

Answer 2

45 degrees

Chest and arms

Question 3

Where do you look for general examination?

Answer 3

Hands and nails
Respiratory rate/ rhythm
Pulse
Eyes
Mouth
Neck and Chest

Question 4

What do you look for in the general examination?

Answer 4

Hands and nails - clubbing, peripheral cyanosis, tar staining

Respiratory rate/ rhythm - done with the breathing rate

Pulse - tachycardia, bounding

Eyes - anaemia, jaundice, horners syndrome (pupil constricted, eyelid drooped)

Mouth - hydration, central cyanosis

Neck and chest - lymph nodes (neck, axillary, virchows), JVP hepato-jugular reflex

Question 5

Inspection

Answer 5

1. Scars
2. Shape of chest (excavatum and carinatum)

Take deep breath:

3. Symmetry
4. Pain

Question 6

Palpation

Answer 6

1. Trachea position
2. Chest expansion
3. Apex beat - 5th ICS, MCL

Question 7

Percussion

Answer 7

Supraclavicular fossae + axillae

Compare both sides

Question 8

Auscultation

Answer 8

Supraclavicular fossae + axillae

Compare both sides

Vocal resonance

Compare both sides

Question 9

Extras at the end

Answer 9

1. “I would examine for tactile fremitus”
2. Inguinal lymph nodes
3. Lower limb oedema
4. Mention sacral oedema if present
5. “I would also measure peak flow and oxygen saturation”