Respiratory Examination

Question 1

Introduction

Answer 1

WASH HANDS
Hello, my name is Jessica Eze I am a first year medical student. Can I firstly take your full name and DOB.
And how would you like to be addressed

Question 2

Assessment of patient

Answer 2

Alert
Upright
Breathing normally
Not in distress
No signs of sweating or facial acromegaly

Question 3

Assessment of environment

Answer 3

No nebuliser or inhaler
No breathing equipment
No vomit bowl or sputum pot
Any medications
NEWs chart? Read it

Question 4

Hands

Answer 4

1. Temperature/ and Joint pain
2. Tar staining
3. Peripheral cyanosis
4. Capillary Refill
5. Palm of hands- temp, creases, nodules/rash
6. Clubbing
   a) Nail fluctuations
   b) Diamond
7. Fine and Flapping Tremor
8. Pulse and Resp rate (Rate, rhythm, volume and character)

Question 5

Arms

Answer 5

Venous Damage
Scars/Bruises
BCG scar
Hydration

Question 6

Head

Answer 6

Conjunctiva- pink
Sclera- clear
Face symmetry and colour
Mouth: angular stomatitis, central cyanosis, tonsils, ulcers, gingivitis

Question 7

Lymph nodes

Answer 7

Cervical Lymphadenopathy
Supraclavicular
Cervical chain 
Tonsillar
Submandibular
Submental
Pre and Post auricular
Occipital

Question 8

Neck

Answer 8

Tracheal position

Crico-sternal distance

Question 9

Front of chest

Answer 9

Mediastinal position- apex beat:
1. Find apex beat furthest end
2. Use sternal angle to identify where it is
3. 5th intercostal space, midclavicular
Scars/Skin lesions/Spider naevi
No visible abnormalities with sternum or chest wall
Inspect
Palpate- asymmetry
Percussion- dull/resonant
Auscultation (breathing and vocal resonance)- Vesicular/crackles/wheezes/rubs/Clear

Question 10

Back of chest

Answer 10

Scars/skin lesions
Kyphosis
Scoliosis
Palpate- asymmetry
Percussion- dull/resonant
Auscultation (breathing and vocal resonance)- Vesicular/crackles/wheezes/rubs/Clear