The Respiratory Exam
Through inspecting, palpating, percussing and auscultating the chest, it is possible to comprehensively assess for respiratory pathology.
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Look Around the Room
Cigarettes, O2 devices, puffers, other meds
Inspect the Patient
Age, gender, body habitus
Respiratory Effort
Nasal flaring, accessory muscles, recession
Breathing
Respiratory rate, Cheyne-Stokes, Kussmaul
Ask the Patient to Cough
Barking, brassy, whooping, bovine, postprandial
Listen and characterise
Sputum Sample
If available - colour, volume, blood, pus
Asterixis
Arms out, wrists extended (15 sec), look for tremor
Pemberton's Sign
Ask the patient to hold their arms above their head
Assess for Proximal Myopathy
Inspect the shoulder muscles, ask the patient to raise their arms against resistance
Radial Pulse
Rate, rhythm, character, postural change
Respiratory Rate
Taken surreptitiously whilst measuring pulse
Oxygen Saturation