Respiratory Examination

Question 1

Introduction

Answer 1

Wash Hands
Introduce Yourself
Introduce Patient
Explanation
Consent
Pain/Tenderness
Positioning
Exposure

Question 2

General Assessment

Answer 2

Initial assessment, General Observation, Environment, Charts

Question 3

Peripheral Examination

Answer 3

Hands and Nails: Tar Staining, Warmth, Peripheral Cyanosis/Anaemia
Finger Clubbing: Nail Angle, Fluctuation, Nail Curvature, Bulk of soft tissues
Capillary Refill
Tremor: Fine+Flapping

Measure: Pulse Rate, RR
Look at Arms

Head: Conjunctivae (pallor and anaemia), Tongue and Lips (central cyanosis), Face for redness/swollen

Neck: Tracheal Position, Crico-sternal distance and Lymph Nodes

Question 4

Back of Chest

Answer 4

Position: Lean Forward/Over Pillow
Inspection: Scars, Abnormalities, Asymmetry, Kyphosis/Scoliosis. Lesions/Dilated Veins

Palpitation: Lung Expansion (bases, apices and midway)

Percussion: Apices, Upper, Middle, Lower Zones and Axilla

Auscultation: Apices, Upper, Middle, Lower Zones and Axilla. Diaphragm, breathe In and Out.
Vesicular or Bronchial. Loudness of Sounds. Added Sounds? Abnormalities?
Vocal Resonance: 99 whilst auscultating in areas mentioned

Question 5

Front of Chest

Answer 5

Inspection: Scars, Abnormalities of Sternum/Chest Wall. Skin Lesion/Dilated Veins

Palpation: Mediastinal Position (Tracheal Position, Apexa Beat, Mediastinal Displacement). Check Expansion (Bases, Apices and Midway)

Percussion: Apices, Upper, Middle, Lower Zones and Axilla. Clavicles percussed directly. Heart- dull sound

Auscultation: Apices, Upper, Middle, Lower Zones and Axilla. 99

Question 6

Closure

Answer 6

Thank Patient
Tell them you have finished
Allow them to redress
Clean Hands
Consider bed side tests