Respiratory Exam
 

Chest Expansion

 
 
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Overview

  • Assessing for chest expansion (symmetric or asymmetric) provides clues regarding the presence of chest wall pathology, lung volume loss or obstruction.
    • How to Assess

    • While the patient is in maximal expiration, place your palms over the patient's posterolateral ribs with your thumbs touching in the midline. Ask the patient to take a deep breath in and measure the distance that the thumbs move apart.
  • Measure both anteriorly and posteriorly, comparing measurements.
    • Causes of Decreased Chest Expansion

    • Bilateral

    • Airway obstruction - asthma, COPD
    • Pulmonary fibrosis
    • Musculoskeletal - arthritides, rib fracture
    • Unilateral

    • Pneumothorax
    • Atelectasis
 
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