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    Examination of The Respiratory System

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    kenners
    James Wight outlines the steps to examine the respiratory system, beginning with washing hands, introducing oneself, and positioning the patient at 45 degrees. The examination involves inspection of the patient, bedside equipment, hands, face, eyes, mouth, and neck. Palpation includes checking the trachea, lymph nodes, apex beat, and chest expansion. Percussion and auscultation of the chest are performed anteriorly and posteriorly. The examination concludes by checking for ankle and sacral edema and thanking the patient.

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    Examination of The Respiratory System

    Uploaded by

    kenners
    12K views2 pages
    James Wight outlines the steps to examine the respiratory system, beginning with washing hands, introducing oneself, and positioning the patient at 45 degrees. The examination involves inspection of the patient, bedside equipment, hands, face, eyes, mouth, and neck. Palpation includes checking the trachea, lymph nodes, apex beat, and chest expansion. Percussion and auscultation of the chest are performed anteriorly and posteriorly. The examination concludes by checking for ankle and sacral edema and thanking the patient.

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    Examination of the Respiratory System

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    James Wight outlines the steps to examine the respiratory system, beginning with washing hands, introducing oneself, and positioning the patient at 45 degrees. The examination involves inspection of the patient, bedside equipment, hands, face, eyes, mouth, and neck. Palpation includes checking the trachea, lymph nodes, apex beat, and chest expansion. Percussion and auscultation of the chest are performed anteriorly and posteriorly. The examination concludes by checking for ankle and sacral edema and thanking the patient.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    12K views2 pages

    Examination of The Respiratory System

    Uploaded by

    kenners
    James Wight outlines the steps to examine the respiratory system, beginning with washing hands, introducing oneself, and positioning the patient at 45 degrees. The examination involves inspection of the patient, bedside equipment, hands, face, eyes, mouth, and neck. Palpation includes checking the trachea, lymph nodes, apex beat, and chest expansion. Percussion and auscultation of the chest are performed anteriorly and posteriorly. The examination concludes by checking for ankle and sacral edema and thanking the patient.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
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    James Wight

    Examination of the Respiratory System

    • Wash your hands.


    • Introduce yourself to the patient, and ask permission to examine them.
    • Expose the patient, and position them at 45°.

    Inspection
    Look around the bed Oxygen mask/nasal prongs, sputum pot, drips, PEFR,
    inhalers, nebuliser, cigarettes
    Look at the patient Comfortable at rest, cyanosis, breathless, use of
    accessory muscles, scars (eg following a rib for
    pneumonectomy), asymmetry, deformity, hyperexpansion
    (Barrel chest), pectus carinatum, pectus excavatum,
    cachexia, radiotherapy marks, chest drain
    Look at the hands Clubbing (purulent lung disease – CF, bronchiectasis,
    bronchogenic carcinoma – but not small cell), peripheral
    cyanosis, nicotine staining, muscle wasting, CO2 retention
    flap, tremor (β2-agonists)
    Feel the radial pulse Assess rate and count respirations
    Ask for blood pressure Enquire about pulsus paradoxus
    Look at the face Ptosis, Miosis and Anhydrosis (Horner’s), SVC
    obstruction
    Look in the eyes Anaemia
    Look in the mouth Central cyanosis, pursed lips, tonsils, hoarse voice,
    stridor.
    Look at the neck Examine the JVP (raised in cor pulmonale and tension
    pneumothorax)

    Palpation

    Check trachea is central Including the cricosternal distance


    Check for lymphadenopathy
    Feel for the apex beat May be displaced, eg in pneumothorax or effusion
    Assess chest expansion
    anteriorly

    Percussion
    Percuss anteriorly Compare L with R, and don’t forget the axillae and
    supraclavicular regions. Can be normal, hyperresonant,
    dull and stony dull.
    Auscultation
    Auscultate anteriorly, Compare L with R, listening for air entry, crackles,
    asking pt to breath though wheeze and bronchial breathing. Don’t forget the
    their mouth supraclavicular regions and axillae.
    Assess vocal resonance, Compare L with R, listening for increased vocal
    asking pt to say 99 resonance

    Repeat chest expansion, percussion and auscultation posteriorly, with the patient’s
    arms crossed in front of them.

    Final manoeuvres
    Examine for ankle and
    sacral oedema
    Thank the patient and
    cover them up

    I would complete my examination by….


    “I would like to take a blood pressure, examine the sputum pot, look at the observations
    chart (temperature, sats) and perform a peak flow measurement”.

    Glossary

    Pectus carinatum – a chest deformity in which the sternum bulges forwards (‘pigeon chest
    deformity’)
    Pectus excavatum – a chest deformity in which the sternum caves inwards
    Cachexia – severe wasting usually associated with cancer

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