Thorax & Lungs

Question 0

When inspecting the thoracic cage, what is being looked for/at?

Answer 0

• shape - symmetrical and elliptical
• configuration - ribs angle 45
• anteroposterior-transverse diameter
• neck and trapezius muscles
• skin/lips/nails colour
• respiration
• symmetrically placed hemithorax scapulae

Question 1

What are the major components of the thorax and lung examination?

Answer 1

Inspection

• thoracic cage shape, configuration
• respirations
• skin colour & condition
• position
• facial expression
• level of conscious

Palpation

• confirm symmetric expansion
• tactile fremitus
• detect any lumps, masses, tenderness, temp, moisture, lesions

Percussion
-over lung fields

Auscultation

• assess normal breathing sounds
• note any abnormal breath sounds
• note any adventitious sounds

Check pulse oximetry

Question 3

When inspecting respirations as part of the thoracic and lung exam, what is being looked for/at?

Answer 3

• rate
• effort
• rhythm
• noise
• lag

Question 4

palpate the posterior thoracic cage

Answer 4

• palpate generally for tenderness looking for lumps masses, lesions.
• using dorsal portion of hand check temperature
• locate t9/t10 using c7 landmark and check for SYMMETRICAL EXPANSION
• palpate for TACTILE FREMITUS across top of lung field (above scapula) then down back between scapula, down lung borders comparing sites bilaterally
• have patient say blue moon or ninety nine

Question 5

what are the main categories of a thoracic exam?

Answer 5

inspection
palpation
percussion
ausculation
oximetry

Question 6

auscultate the posterior thoracic cage

Answer 6

-use diaphragm
-listen at 9 sites down back on each side, starting at top of lung field (shoulder)
-expected sounds are normal breath sounds, vesicular and possibly bronchovesicular over trachea areas
(vesicular sounds have a longer inspiration than expiration…bv equal length)