Respiratory Examination

Respiratory examination need to be done fast because it involve examination of the chest and the back.



Important points to ponder

1) NEVER FORGET the RESPIRATORY RATE. --> common killer in short cases

2)Do the asterixis properly. Do not look like you have never done it before.

3) Hypertrophic pulmonary osteoarthropathy is peculiar to chronic pulmonary disease. So, in the exam, say HPO instead of clubbing, which is not specific, as it may be caused by some gastro and cardiac problems.

4)BCG scar --> impress some lecturers with this inspection, annoy others with it.

5) face, don't forget Horner's,nasal polyp, nasal septal deviation,central cyanosis, pharyngitis etc.

6) Neck--> Trachea(be gentle) and lymph nodes(do it fast, don't waste time here)

7) Trunk--> examine front and back except when told otherwise. Chest expansion, do properly. Ur thumbs should go away from each other when the patient INSPIRATE. Make sure ur thumbs are opposed when the patient expirate. To do this, cekik the patient chest during expiration. Ask any previous medicine posting ppl to demonstrate this.
Vocal fremitus is described as equal bilaterally, reduced on what site. DOnt say vocal fremitus is normal.
Percuss at least 8 spots on the chest including the base, which is in the MID axillary line.
Auscultate all ZONES, not lobe. There are 3 zones of the lung, while there is 3 and 2 lobes. Always describe breath sound as being vesicular(normal), bronchial(lobar pneumonia) etc. Do not say breath sound is normal. If crepitation is present, describe it. Pan inspiratory or mid inspiratory, coarse of fine and at which zone. E.g. bibasal mid inspiratory fine crepitation.

dont forget pedal edema :)