Respiratory exam

Question 1

Introduction

Answer 1

Clean hands
Introduction
Check name and DOB/age
Explanation and gain consent

Question 2

End of Bed

Answer 2

Immediate intervention required?
In pain?
Sputum pots/oxygen mask/NEWS chart/ medication

Question 3

Hands and arms

Answer 3

Tar staining
Compare nail colour (peripheral cyanosis)
Finger clubbing
Temperature
Capillary refill time
Fine tremor (B2 agonist overuse)
Flapping tremor (CO2 retention)
Measure pulse and check resp rate
Check arms for track marks

Question 4

Head and neck

Answer 4

Colour of the conjunctivae (anaemia
Tongue and lip colour (central cyanosis)
Look at face, any swellings, patches of inflammation
Tracheal position and crico-sternal distance
Lymph nodes

Question 5

Cervical lymph nodes?

Answer 5

Supraclavicular
Anterior cervical chain
Tonsillar
Submandibular
Submental
Preauricular
Postauricular
Posterior cervical

Question 6

Back of chest

Answer 6

Inspection - scars, spine (scoliosis/ kyphosis), skin changes
Palpation - lung expansion
Percussion - apices, upper, mid, lower zones, mid axillary
Auscultation - vesicular, bronchial added sounds?
Vocal resonance

Question 7

Front of chest

Answer 7

Inspection - scars (could be hidden), sternal abnormalities, skin lesions
Palpation - apex beat, chest expansion
Percussion - apices to mid axillary line
Auscultation - breath sounds and vocal resonance

Question 8

Conclusion

Answer 8

Thank patient, help them get dressed, clean hands