Resp OSCE Flashcards
What are the first things you should do?
Wash hands, introduce self, identify patient, gain consent.
what are you looking for in the hands and arms
hands:
clubbing, tar staining, erythema, temp, clammy, wasting of intrinsic muscles
Arms:
asterixis, pulse rate, rhythm and character
what does a bounding radial pulse indicate?
CO2 retention
what respiratory condition can cause a raised JVP
cor pulmonale
what causes asterixis
co2 retention
when should you assess resp rate?
when assessing pulse
what resp signs are you looking for in the face
eyes:
anaemia, horners syndrome, chemosis
face:
facial swelling, dental caries, central cyanosis
what is chemosis indicative of?
hypercapnia 2nd to COPD
what can dental caries cause
aspiration
what can svc obstruction cause
facial swelling
what are you looking at in the chest (general inspection)
Shape:
barrel? kyphoscoliosis? pectus excavatum? pectus carinatum
symmetry:
scars, muscle wasting, chest vs abdo breathing, accessory muscles, recession
what are you palpating anteriorly?
TRACHEA, APEX BEAT
chest expansion
tactile vocal fremitus
where are you percussing anteriorly?
four on left and right and two mid axillary
what instruction do you need to give the patient when auscultating?
open mouth breathing!
what asseses for consolidation when auscultating?
vocal resonance- say 99
