Respiratory System Examination

Respiratory System Examination

Upper Respiratory Tract

Nose

  1. Nasal septum
  2. Flaring
  3. Ala nasi
  4. Nasal discharge
  5. Bleeding
  6. Foreign body

Pharynx

  1. Redness
  2. Tonsil enlargement

Lower Respiratory Tract

INSPECTION

Shape of Chest

  1. AP and transverse diameter
    1. Rickets / Pigeon breast / Keeled chest / Pectus carinatum
    2. Funnel chest / Cobbler's chest / Pectus excavatum
    3. Barrel shape chest
  2. Hollowing, bulging, flattening or retraction
  3. Sub-costal angle
  4. Shoulders
  5. Spines
  6. Spinoscapular distance on both sidesb

Respiratory Movement

  1. Respiratory rate 
  2. Rhythm
  3. Character
    1. Abdominal
    2. Thoracic
    3. Thoraco abdominal
    4. Abdomino thoracic
  4. Equality
  5. Accessory muscle of respiration
    1. Sternocleidomastoid
    2. Pectoralis major / minor
    3. Serratus anterior
    4. Serratus posterior superior
    5. Latissimus dorsi
  6. Intercostal retraction / fullness

Mediastinum

  1. Trailes sign
  2. Apex impulse

Miscellaneous

  1. Scars
  2. Sinuses
  3. Pulsations
  4. Dilated veins
  5. Shiny skin over lower chest (Empyema, Hepatic amebiasis)

PALPATION

Findings of inspection confirmed including chest movement

Mediastinum

  1. Trachea
  2. Apex beat

Tactile vocal fremitus

Miscellaneous

  1. Tenderness over lower intercostal spaces
  2. Other vibration: Palpable rales, rhonchi, rub

PERCUSSION

Anteriorly

Supraclavicle
Clavicle
Infraclavicle
Mammary
Inframammary

Right side                              Left side
Kronig's isthmus                    Kronig's isthmus
Clavicular percussion            Clavicular percussion
Intercostal resonance            Intercostal resonance
Liver dullness                        Cardiac dullness
Tidal percussion                    Traube's area
Shifting dullness                    Shifting dullness
Percussion myokymia           Percussion myokymia
Skodaic resonance               Skodaic resonance

In Axilla

Axillary
Infraaxillary

Posteriorly

Suprascapular
Interscapular
Infrascapular

AUSCULTATION

Breath Sounds

  1. Normal or diminished
  2. Type
  • Vesicular
  • Bronchial
    • Tubular
    • Cavernous
    • Amphoric
  • Vesicular with prolonged expiration

Foreign Sounds

Rales
Rhonchi
Rub

Vocal Resonance

Miscellaneous

  1. Bronchophony
  2. Egophony
  3. Whispering pectoriloquy
  4. Succussion splash
  5. Coin test
  6. Post-tussive suction
  7. Post-tussive rales

Comments

Post a Comment

Popular posts from this blog

Lumbar Puncture Procedure

Lumbar Puncture Procedure Indication Diagnostic Meningitis Therapeutic Administration of drugs Decrease intracranial pressure Guillain – Barré syndrome Contraindication Increased ICP Patients under anticoagulant therapy Procedure If patient is under anticoagulant therapy Heparin Stop the drug 4 days prior to the procedure Aspirin Stop the drug 7 days prior to the procedure Instruments Lumbar puncture needle 22 Gauge Anaesthesia Injection Lignocaine Sample collection 3 samples 10ml each sample Microbiology Histopathology If repeated procedure indicated After 5 days of the previous procedure Complication Brain stem herniation Post dural headache Due to decreased ICP Prevented by 1 hour lying down before getting up Prevented by administration of paracetamol, caffeine, blood (epidural patch) Bowel & bladder incontinence Nerve damage due to negative pressure Infection
Read more

History Taking

History Taking General Pain Location Since when Onset Duration Type Character Radiation Progression Aggravating / Relieving factor Postural variation Diurnal variation Seasonal variation Joint Pain Since when Onset Duration Type Character Which joint Any swelling, redness, wound Restriction of movement Aggravating / relieving factor Medication taken Postural variation Diurnal variation History of: Exercise Work Fall Fever Weakness Since when Generalised or not Whether it is due to diet Whether it is due to fever Fever Since when Onset Grade: High/Low Continuous/Intermittent Spikes per day if intermittent Worse in the morning/evening/night Associated with chills/Rigors Progression Diurnal variation Seasonal variation Medication taken Rashes Since when Which part of body Initial size Current size What colour Progression  Presence of itchiness Generalised / Localised  Symmetrical ...
Read more

Furqan - Nabi Isa Ibni Maryam

Image
An-Nisa' 4:171 O People of the Scripture, do not commit excess in your religion or say about Allah except the truth. The Messiah, Jesus, the son of Mary, was but a messenger of Allah and His word which He directed to Mary and a soul [created at a command] from Him. So believe in Allah and His messengers. And do not say, "Three"; desist - it is better for you. Indeed, Allah is but one God. Exalted is He above having a son. To Him belongs whatever is in the heavens and whatever is on the earth. And sufficient is Allah as Disposer of affairs. Wahai Ahli Kitab! Janganlah kamu melampaui batas dalam agamamu, dan janganlah kamu mengatakan terhadap Allah kecuali yang benar. Sungguh, Al-Masih Isa putra Maryam itu, adalah utusan Allah dan (yang diciptakan dengan) kalimat-Nya yang disampaikan-Nya kepada Maryam, dan (dengan tiupan) roh dari-Nya. Maka berimanlah kepada Allah dan rasul-rasul-Nya dan janganlah kamu mengatakan, "(Tuhan itu) tiga,"Berhentilah (dari ucap...
Read more