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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