Respiratory examination Flashcards
What should be done to initiate the examination?
Wash hands
Introduction
Patient consent
Explanation
How should a patient be positioned?
Patient at 45 degrees
Chest and arms adequately exposed
What should be identified during the general inspection?
Paraphernalia (mobility aids, machinery)
Medication (e.g. oxygen, inhalers, nebulisers)
Difficulty breathing
Obvious scarring or abnormalities
What should be identified when examining the hands?
Peripheral cyanosis
Tremor (associated with Beta-2 agonist use)
Flapping tremor (CO2 retention)
What should be identified when examining the nails?
Tar staining
Clubbing (lung cancer, bronchiectasis)
What vital signs should be taken?
Radial pulse (rate/ rhythm)
Respiratory rate
BP offered
What should be identified when examining the eyes?
Conjunctivae pallor
Upper sclera jaundice
Pupils (miosis)
What should be identified when examining the mouth?
Dehydration (associated with inhaler use)
Central cyanosis
What should be identified when examining the neck and chest?
Lymph nodes Raised JVP Shape of chest (pigeon chest or barrel chest) Scars Chest expansion
What should be palpated?
Deviated trachea (tension pneumothorax)
Chest expansion
Displaced apex beat (tension pneumothorax)
What should be percussed?
Anterior chest
Back
Axillae
What should be auscultated?
Anterior chest
Back
Axillae
Vocal resonance (“1,2”)
What are you listening for when auscultating?
Wheeze/ Stridor
Crackles
What peripheral examinations should be done?
Peripheral oedema (and sacral if present)
What additional tests could be carried out?
Peak flow
FEV1
Spirometry
Oxygen saturation
