Respiratory Examination Flashcards
What position should a patient be in when examining their respiratory system?
Upright, 90 degrees
This may not be possible if the patient is too ill to sit up.
During your discreet general inspection, what are you keeping an eye out for (8)?
- patient’s general mental state
- alertness
- respiratory effort
- coughing
- wheezing
- stridor
- supplemental O2
- sputum cup
When do you look for the peripheral effects of respiratory disease?
List one example of a sign
At the hands, especially the nails.
Clubbing
Broadly, list the 12 steps of the respiratory exam as outlined in PCP2 book
- Prepare the patient
- General inspection
- Hand hygeine
- Hand inspection
- Radial Pulse and Respiratory Rate
- Head and neck inspection
- Anterior and lateral chest inspection
- Measurement of anterior chest expansion x2
- Percussion of the anterior and lateral chest
- Auscultation of the anterior and lateral chest (+vocal resonance test)
- Examination of the posterior chest (expansion, auscultation and percussion)
- Measurement of Peak Flow
Close exam
During examination of the head and neck, what should you assess for?
Lips and tongue for cyanosis
When assessing the trachea, what are you trying to establish?
Its position; midline or deviated
When inspecting the anterior and lateral chest walls, what are you looking for?
Shape of chest
Scars
Pattern of respiration
Use of accessory muscles
What are the accessory muscles of respiration?
.
What are the two sites where anterior chest expansion is measured?
- the lower rib cage with thumbs opposed to each other
- aupper chest wall near clavicles using the flats of your hands
When testing chest expansion what two features are you assessing?
Symmetry and degree of expansion
What sites are percussed during examination of the anterior and lateral chest walls?
Percuss down the mid-clavicular line in every second intercostail space to the liver on the right and the cardiac dullness on the left.
Percuss in two position down the mid-axillary line.
What sites are auscultated in the anterior and lateral chest walls?
Same as for percussion:
Percuss down the mid-clavicular line in every second intercostail space to the liver on the right and the cardiac dullness on the left.
Percuss in two position down the mid-axillary line.
How should the patient breath during auscultation?
In and out through open mouth
After auscultation of anterior and lateral chest walls, what should be performed?
Vocal resonance tests for vocal fremitus
What is vocal fremitus?
The palpable vibration felt over the lung fields when the patient speaks (limited value)
