resp osce

Question 1

intro

Answer 1

hand hygiene, intro, explain, consent, remove top and position pt, VSS

Question 2

look

Answer 2

medication/medical equipment, peripheral cyanosis, cachexia, scars surg/trauma (look at auxiliary) SOB, WOB/accessory muscle use, speech, cough

Question 3

hands

Answer 3

assess colour/ cyanosis/ temp/ cap refil

clubbing (due to Cx low O2)

tar stains

asterixis- flapping of hand from out stretched hands CO2 retention

Question 4

Arm

Answer 4

radial/brachial pulse- rate, rhythm, character-both arms

track marks

Question 5

Neck

Answer 5

JV- pt look to side, find JVP, assess height from sternal notch, <3cm good

lymph nodes- submental, submantible, anterior, posterior, tonsillar, preauricular, post auricular, virchrow’s sign, auxiliary

Assess trachea- place finger above sternal notch, ensure trachea is midline on both sides

Question 6

face

Answer 6

facial plethora- superior cava syndrome ? lung Ca

eyes- conjunctive pallor, ptosis (horner’s syndrome- apathetic lung tumour affecting superior sulcus ), sinus tenderness

mouth- central cyanosis, erythema of pharynx, tonsilis, dentition

Question 6

face

Answer 6

facial plethora- superior cava syndrome ? lung Ca

eyes- conjunctive pallor, ptosis (horner’s syndrome- apathetic lung tumour affecting superior sulcus ), sinus tenderness

mouth- central cyanosis, erythema of pharynx, tonsilis, dentition