Respiratory

Question 1

Inspection

Answer 1

Relaxed breathless - count respiratory rate - 12-8breaths per min
Exam hands 
- cyanosis
- finger clubbing
- increased fluctuation of the nail bed
- palmer erythema 
- radio pulse - rate regulatory 

Flapping tremor - CO2 retention positive test

Face

• central cyanosis - tongue and lips
• palor in eyes - anaemia

Chest - shape symmetry and scars
Kyphosis and scoliosis , barrel chest /pigeon test

Palpation - trachea should be central - feel for wind pipe
Locate apex beat
Expansion of the chest - patient breathing in an out - thumbs resting up from chest wall

Percussion
Tapping - produce resonant or hollow sound - begins with clavicles , continues in intercostal spaces - dullness over liver and heart

Auscultation - deep breaths , side to side listen - and axilla . Normal breath sounds - bronchial breathing - 99 will sound louder on healthy side

Lymph nodes- supraclavicular areas- cancer in the lung