Respiratory System Diagnosis

Question 1

What are the two types of lung percussion

Answer 1

*Topographic percussion
*comparative percussion

Question 2

What should you do

Answer 2

*greet the patient
*choose the right position

Question 3

What should you determine in topographical percussion Iungs

Answer 3

*Apex of the lung
*lower border of the lungs
*mobility of lower border of the lungs

Question 4

Lines of topographical percussion

Answer 4

*parastenal line
*midclavicular line
*Anterior axillary
*Mid axillary
*posterior axillary
*subscapularis
*paravertebral

Question 5

How do u begin the percussion topographic ( apex of lungs)

Answer 5

*apex of the lungs(put your finger in supraclavicular pit (percuss mid upwards till sounds appear dull 5-6cm
*Patient turns back and you percuss to 7 thoracic vertebrae

Question 6

Determination of lower border

Answer 6

You just need to percuss the 7 lines starting with
*parasternal line( percuss down wards till dullness of sounds normally 5 intercostal space
*midclavicular line percuss till dullness of sound normally 6th rib
*anterior axillary( percussion till dullness of sound normally 7th rib
*mid axillary line percussion till dullness of sound normally 8th rib
*posterior axillary line percussion till dull sound normally 9th rib
*ask patient tilt forward then you can see the border of scapula(percuss downwards till dull sound appears normally 10th rib)
*percuss para vertebrae line percussion downwards till sounds become dull normally at 11th rib

Question 7

Mobility of lower border of the lungs

Answer 7

You can choose any line to determine the mobility of the lower border of the lungs
*choose mid axillary line<ask patient to raise their hand
*percuss till dull sound then mark the area
*The ask patient to inhale and hold their breath then you percuss downward when dullness occurs mark it
*Ask patient to inhale then from the first mark percuss upwards till dullness of sound then mark again the marks between them normally should be 3 centimetres

Question 8

What do we determine in Comparative percussion

Answer 8

*pathological murmurs
*pathological sounds in both sides of the lungs
*in comparative percussion there are 4 lines

Question 9

Which lines do we percuss in comparative percussion

Answer 9

*apex supraclavicular line
*midclavicular line
*Mid axillary line
*Suprascapular line

Question 10

How do you perform comparative percussion

Answer 10

*you just compare both one line in both sides of the lungs starting from apex (claviclular pit percuss both sides
*midclavicular line (percussion both sides(finish percussion on the left on the 3rd intercostal space the continue percussion downwards from the right side of the lung dullness stops at 5th intercostal space
*At this moment change position of your fingers to vertical to percuss mid axillary line compare on both sides of the lungs then switch to horizontal and percuss
*lastly suprascapular line (ask patient to tilt forward and hold the hands on their head begin from supraspine percuss and compare on both sides
*then switch to vertical percussion both sides then horizontal again down wards
*normal breathing of the lungs should be vesicular if there are pathologies we will hear amphoteric,metallic sounds

Question 11

Auscultation of the lungs with stethoscope

Answer 11

*Ausculate supraclavicular and compare
*Ausculate subclavin and compare
*Ausculate midclavicular In the left you stop and 3rd intercostal space because of the heart and continue on the right side Ausculate downward wards
*Ausculate mid axillary and compare both sides
*From the back Ausculate from supraspinal compare
*Ausculate paravertebral region avoid bones and suprascapular to lateral positions

Question 12

What are the sounds from the anterior chest and posterior lungs

Answer 12

*Anterior ( vesicular sounds)
*posterior bronchial sounds

Question 13

Pathological sounds of the lungs

Answer 13

Decreased vesicular sounds
Murmurs