Respiratory exam

Respiratory exam

What we can get from this session

• A brief overview of pathology

• An template of how to conduct a resp exam

• An appreciation for signs in the resp exam

Resp exam

• General - much like cardio, have a method

• Focussed

General Exam

• General inspection

• What can we get from this?

We can start with the hands

• What can we look for in the hands and what do they indicate

• Can cancers cause any signs in the hands?

• Any measurements we can take at this point?

Multiple Select

What are the possible respiratory causes for this sign (select multiple)?

• Bronchiectasis

• COPD

• Cystic fibrosis

• Lung cancer

Multiple Choice

What's the difference between checking for normal tremor and asterixis (tick true)?

• Asterixis required the hands to be extended backwards

• Normal tremor implies CO2 retention

What else can we look for in the face and neck

• Signs of poor oxygenation?

• What structures in the neck may be pathologically enlarged and what can cause this?

''Swollen Glands''

• 36 year old, night sweats, productive sputum, recently arrived from bangladesh. Non Smoker

• 18 Year old with sore throat, fever pain on feeling swollen lymph node. Knows people who have had the same thing

• 70 year old lady with lymph node, generally quite tired, night sweats, unexplained recurrent chest infection and new anaemia

Multiple Select

What would you expect on examination of this patient (select multiple) (Can click to enlarge image)?

• Shift of apex beat to the right

• Shift of apex beat to the left

• Shift of trachea to the right

• Shift of trachea to the left

Multiple Select

What would you expect to find with this patient (select multiple) (Can click to enlarge image)?

• Shift of apex beat to the right

• Shift of apex beat to the left

• Shift of trachea to the right

• Shift of trachea to the left

Multiple Choice

What is the correct framework for focused examination (select one)?

• Inspection, Auscultation, Percussion, Palpation

• Inspection, Percussion, Palpation, Auscultation

• Inspection, Palpation, Percussion, Auscultation

• Inspection, Auscultation, Palpation, Percussion

Multiple Select

Which of these could we assess with inspection?

• Work of breathing

• Scars

• Chest expansion

• Chest wall deformities

Multiple Select

If there is asymmetrical chest expansion what would this suggest?

• Pneumothorax

• Lobar/ Lung Collapse

• Mild pneumonia

• COVID

Percussion

Why do we do percussion?

Where do we percuss?

What are the findings we can get from this?

Multiple Choice

What would you expect with a pneumothorax?

• Hyperresonant

• Normal

• Dull

• Stoney dull (minimal percussion)

Multiple Choice

How about a pleural effusion?

• Hyperresonance

• Normal

• Dull

• Stony dull

Open Ended

What is '' vocal tactile fremitus'' ? (don't have to use medical terms)

Auscultation

Same areas as percussion, listening for what?

Lets listen to some

What do we do posteriorly

What else can we look for?

Then Le FIN.