Respiratory

Question 1

Introduction

Answer 1

State name, level in career and confirm ID.

Explain the purpose of the examination and ask for consent.
- Expose from waist up.

Wash hands

Place patient sat upright

Question 2

End of bed observation

- General

Answer 2

Well/ ill?

Comfortable/ distressed?

SOB?

Medical devices?

• Asthma pump
• O2 tanks

Question 3

End of bed observation

- Signs of respiratory distress

Answer 3

Pursed lipped breathing

Intercostal recession

Use of accessory respiratory muscles

Respiratory splinting (reduced inspiratory effort due to pleuritic chest pain)

Question 4

Hands

Answer 4

Finger clubbing

Cigarette tar staining

Peripheral cyanosis

Question 5

Arms

Answer 5

Radial pulse+ checking resp rate

• Rate
• Rhythm
• Bounding?

CO2 retention flap

Question 6

Face

Answer 6

Eyes
- Anaemia: Conjunctival pallor

Mouth
- Central cyanosis

Question 7

Neck

Answer 7

Lymph nodes:

• Post auricular
• Submandibular
• Paratracheal

Tracheal deviation

Question 8

Chest

- Inspection

Answer 8

Shape of the chest

• Barrel
• Pigeon chest
• Concave

Scars

• Tracheotomy
• Sternocotomy

Question 9

Chest

- Non inspection

Answer 9

Chest expansion
- Symmetrical?

Percussion on both sides
- Resonance, dullness?

Auscultate

• Wheeze
• Crackles

Question 10

Back

Answer 10

Percussion
- Resonance, dullness?

Auscultation

Question 11

Special investigations

Answer 11

Peak flow

ABG?