Respiratory Examination

Question 1

General Inspection

Answer 1

Oxygen, medications
General health and wellbeing - dysmorphic features 
Ability to speak comfortably
Effort and work of breathing 
Audible noises
PEWS

Question 2

Resp distress

Answer 2

Nasal flaring 
Intercostal and subcostal recessions
Tracheal tug 
Abdominal breathing 
Head bobbing 
Use of accessory muscles

Question 3

Hands

Answer 3

Finger clubbing
Cannula sites
Peripheral perfusion and cyanosis

Question 4

Arms

Answer 4

Pulse rate and rhythm

Question 5

Eyes, nose, mouth and neck

Answer 5

Pallor, jaundice, polyps and central cyanosis

Cervical and axillary lymphadenopathy

Question 6

Inspection

Answer 6

Look for scars (tracheostomy, chest drain, midline sternotomy, lobectomy, PDA scars)
Shape of chest (pectus excavatum / pectus carinatum, Harrison’s sulcus, barrel chest)
Central lines (Hickman line, porta-Cath can be felt on palpation)
Spine (kyphosis / scoliosis)

Question 7

Palpation

Answer 7

Trachea central

Chest expansion

Question 8

Auscultation

Answer 8

Quality - vesicular or bronchial breath sounds
Volume - air entry (reduced / equal)
Added sounds - creps, crackles, wheeze

Question 9

Also….

Answer 9

PEFR
Inhaler technique
Plot height and weight
Abdo and cardio examinations if appropriate