Respiratory Sytem: Examination

Question 1

What are the normal anatomical markers for chest area

Answer 1

Ribs and intercostal spaces: start count from second rib ( attached to sternum at sternal angle) since first rib covered by clavicle
Place thumb on upper edge, index on lower edge

Count the vertebra from c7 bc. It’s prominent- ask patient to bend head forwards

Supraclavicular and infraclavicular fossae are separated by clavicle SCM, and trapezoid. Lung tip is oercussed in the area

Question 2

What are some anatomical lines used in the frontal plane

Answer 2

Midsternal line
L/R sternal lines
L/R para sternal lines
L/R mid clavicular lines

Question 3

Anatomical lines on lateral surface of chest

Answer 3

Anterior axillary
Mid axila,eh
Post axillary

Question 4

Anatomical lines on posterior chest surface

Answer 4

L/R scapular lines
L/R para vertebral lines
Posterior midline

Question 5

What is. NOn comparative chest inspection

Answer 5

Skin
Shape chest
Ventilation character
Spine morphology

Question 6

What should you look out for in skin

Answer 6

Hyperpigmentation: brown black colour and velvet like structure may indicate lung tumours w ectopic insulin production

Vascular stars: anterior edge of thorax may mean liver cirrhosis

Gynecomastia: benign growth of mammary glands could indicate serious disease like cirrhosis

Dilated venules

Rashes

Operative scars

Question 7

What are the different chest shapes

Answer 7

Normosthenic: normal physique, thoracic cage symmetric sternal angle 90

Hyperasthenic: more wider physique. Ribs more horizontal, inspire a lot, sternal angle greater than 90

Authentic: thinner people, ribs go down steep,y , sternal angle sharp

Question 8

Pathological forms of chest

Answer 8

Barrel shaped chest: round, short, wide deep shape, shoulders raised upwards. Supraclaviclar fossae flat and convex, ribs raised up. Sternal angle obtuse. EMPHESEMA PATIENTS

Paralytic chest: flat, narrow, long like asthenic chest but transversal diameter reduced. Sternal angle less than 50. CHRONIC LUNG DIEASES

Deformed chest: Affects normal curve of spine

Question 9

What are some types of deformed chest

Answer 9

Kyphosis: chets symmetrical but thoracic part spine increases convexiry and forms arc. Chest becomes narrow

Scoliosis: s shaped curvature in thoracic part

Kyphoscoliosis: most common, may disturb breathing, ventilation perfusion ratio etc. lead to respiratory failure type 1+2.assymetry of shoulders, sternum depressed, spine and ribs twisted,OSTEOMALACIA,TUBERCOLISIS

Birds chest : turner syndrome

Richest chest :