Physical Exam Chest

Inspection

• Skin
  • Color: erythema, ecchymosis, white, black
  • Trophic changes (altered hair growth, sweat production)
  • Scars
  • Abrasions, deformities
• Muscle tone: atrophy, hypertrophy
• Deformity: asymmetry, rotation, amputation
• Respiratory status
  • Rate: tachypneic, bradypneic or eupneic?
  • Ventilation: hyperpnea, hypopnea?
  • Accessory muscle use?
  • Position of patient: upright, tripod position
  • Speaks in complete sentences
  • Symmetric chest rise
  • Trachea is midline
  • Color: cyanotic or acyanotic
• Chest
  • Pectus excavatum or carinatum

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Palpation

• Palpate for
  • Effusion
  • Clicking
  • Snapping
  • Crepitus
  • Tenderness
  • Temperature
  • Masses
• Areas of Emphasis
  • Tactile fremitus
  • Peripheral pulses (regular, irregular, weak, bounding)

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Percussion

• Sounds
  • Resonant: normal
  • Flat or dull: abnormal suggesting soft tissue or fluid
  • Hyperresonant: abnormal suggesting air such as pneumothorax
  • Tympanic

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Auscultation

• Lung sounds
  • Normal (vesicular)
  • Wheezing
  • Rales (crackles)
  • Ronchi
  • Pleural Rub
  • Stridor
  • Absent
• Cardiac
  • S1 and S2
  • Rate (slow, fast, normal)
  • Rhythm (regular or irregular)
  • Murmur
  • Rub
  • Gallop

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Special Tests

• Egophony: ask the patient to say "Eeeee," and it will sound like an "A."
  • Suggestive of consolidation, pleural effusion.
• Pectoriloquy:

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See Also

• Cardiac (Main)
• Pulmonology (Main)
• Physical Exam (Main)

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