Saturday, May 30, 2009

Chest Examination

General Examination:

Local Examination:

Inspection: must include: 1-Shape (normal elliptical, increased A-P diameter or hyperinflated, barrel, pigeon) 2-Movement 3-Symmetry 4-RR and type of breathing 5-Visible pulsations and apical pulsation site 6-Skin (scars, dilated veins, pigmentations) 7-Special signs (litten's and trill's signs) Palpation: must include: 1-Trachea (as a sign for mediastinal shift) 2-Tenderness 3-Movement 4-Tactile vocal fremitus 5-Paplable pulsations or rhonchi Percussion: includes: 1-Comparative percussion (light anteriorly and heavy posteriorly) 2-Detecting bare area of the heart (dull) 3-Detecting traub's area (tympanitic) 4-Detecting kronig's isthmi (dull --> resonant --> dull) 5-Tidal percussion (for diaphragmatic motility) Auscultation: includes: 1-Equality of breath sounds 2-Intensity of breath sounds 3-Type of breath sounds (vesicular, bronchovesicular, bronchial) 4-Adventitious sounds (crepitations, rhonchi --> site in breathing, intensity) 5-Vocal resonance

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