Lungs being the only organ to float on water, its extensive peculiarity lies when to learn to pick up different lung sounds and associate them to the clinical condition…
Enter
Greet the Examiner
Sanitize your hands
Introduce yourself to the examiner
Check If The Patient Is Short Of Breath At Rest, See For Usage Of Any Accessory Muscles, Pursed Lip Breathing, Intercostal Indrawing, Scar Marks, Any Audible Noises, Ask The Patient To Cough
LOOK AROUND, ANY INHALERS, OXYGEN DELIVERY DEVICES, CPAP DEVICES, NEBULISERS, SPUTUM POT (IF YOU SEE A SPUTUM POT YOU ARE EXPECTED TO OPEN IT UP AND CHECK)
Note Any Deformities Of The Chest WallPectus ExcavatumPectus CarinatumKyposcholiosisBarrel Shaped Chest
Look For Any Cushingoid Appearance
Begin Examination Asking The Patient To Raise His Hands With Wrists Extended. Asterixis Checked, Look, On Dorsal Aspect, For Clubbing, Cyanosis(Peripheral), Splinter Hemorrhages, Leukonychia Or Koilonychia, Onycholysis, Nail Pitting, Nicotine Staining (Not To Mention In Abdomen Station), Then Ask The Patient To Turn The Hands Over To Examine The Palmar Aspect For – Radial Artery Scar, Dupuytren’s Contracture, Thenar & Hypothenar Wasting, Check The Pulse. No Need To Check Both Sides, Or For Collapse
Inspect The Jvp, Also Part Of Resp Exam, Talks About Corpulmonale
Look For High Arch Palate, Dental Hygiene, And Tongue (Undersurface Of Tongue Cyanosis, Gingival Hyperplasia (Nifedipine, Cyclosporine Toxicity)
Always start with the inspection Adequately expose the Chest and inspect, check if the chest wall movements are bilaterally symmetrically, notice any distended veins, scars, scars over chest wall. Any surgical or ICD scar, Note Any Deformities Of The Chest WallPectus ExcavatumPectus CarinatumKyposcholiosisBarrel Shaped Chest.
Palpate For The Tracheal Position, Check Which Side It Is Deviated Mostly It’s The Pathological Side Unless You Are Dealing With A Massive Pleural Effusion, Also Check Cricosternal Notch Distance Which Will Be Reduced In Copd.
Go Backkkkk! Respiratory System The Money Is On The Back. Don’t Waste Your Time Once You Determined The Tracheal Position
Palpate for lymph nodes
Palpate For Breath Movements, Check For Sacral Edema
Check For Pedal Edema
Percuss anterior chest wall
FRONT: Auscultate all the lung fields Vocal resonance is important
BACK: Auscultate all the lung fields Vocal resonance is important
Concluding: Thank the patient, offering to help dress him up, wash hands and turn to the examiner.
