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Respiratory Exam
Respiratory Exam

Chest Deformities

July 1st, 2020


Chest wall deformities may be an external sign of an underlying disease, or may themselves cause significant restrictive pulmonary disease.

Barrel Chest

  • Look For

  • A rounded, bulging chest.
  • Causes of Barrel Chest

  • Physiological
  • Hyperinflation - acute asthma, late emphysema
  • Osteoarthritis

Pectus Excavatum

Also known as funnel chest.
  • Look For

  • Inward depression of the sternum.
  • Causes of Pectus Excavatum

  • Marfan syndrome
  • Congenital heart diseases

Pectus Carinatum

Also known as pigeon chest.
  • Look For

  • Forward angulation of the sternum
  • Causes of Pectus Carinatum

  • Marfan syndrome
  • Down syndrome


  • How to Elicit

  • Inspect the spine, and then palpate the spinous processes of the vertebrae.
  • Look For

  • Lateral curvature of the spine
  • Distortion of the trunk
  • Prominence of the ribs
  • Asymmetry of skin folds around the flank
  • Shoulder elevation
  • Scapular rotation
  • Causes of Scoliosis

  • Idiopathic (80%)
  • Congenital - maldevelopment of vertebrae
  • Neuromuscular disorders - cerebral palsy, muscular dystrophy
  • Syndromal - Marfan, neurofibromatosis, Down syndrome
  • Trauma - fracture, dislocation, burns
  • Degenerative - secondary to facet joint osteoarthritis
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