1 / 20

Physical Examination of the Chest

Physical Examination of the Chest. RC 275. Chest Topography: Anterior Chest. Chest Topography: Lateral Chest. Chest Topography: Posterior Chest. Fissures:. Location of Lobes. Physical Exam Techniques. Observation Palpation Percussion Auscultation.

finley
Download Presentation

Physical Examination of the Chest

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Physical Examination of the Chest RC 275

  2. Chest Topography: Anterior Chest

  3. Chest Topography:Lateral Chest

  4. Chest Topography:Posterior Chest

  5. Fissures:

  6. Location of Lobes

  7. Physical Exam Techniques • Observation • Palpation • Percussion • Auscultation

  8. Observation • Patient ‘s surroundings, ie: the view from the door • Equipment present • Posted signs • SPUTUM!

  9. Observation:Breathing Patterns • Eupnea • Tachypnea/Bradypnea • Biot’s • Cheynes-Stokes • Kussmaul

  10. Observation:Thoracic Contour

  11. Observation: Thoracic Contour(cont.) • Pectus Excavatum • Pectus Carinatum • Kyphosis • Scoliosis • Kyphoscoliosis • Symmetry of chest movement

  12. Observation: Clubbing

  13. Palpation: Tracheal Alignment

  14. Tracheal Alignment Abnormalities • Pneumothorax – shifts to unaffected side • Pleural Effusion – shifts to unaffected side • Fibrosis or Atelectasis – shifts towards affected side • Pulmonary consolidation – no shift

  15. Palpation : Chest Excursion

  16. Palpation: Vocal Fremitus • BILATERAL comparison of vocal vibrations • Increased with alveolar consolidation • Decreased with increased distance between lung and chest wall • Pneumothorax, Pleural effusion

  17. Percussion • Assess density of underlying tissue

  18. Percussion Notes • Resonance – normal • Dullness – increased density • Atelectasis, alveolar filling/consolidation, pleural effusion, fibrosis • Hyperresonance – decreased density • Hyperinflation (COPD), Pneumothorax

  19. Case Study A patient is recently diagnosed with RLL bronchogenic CA. As you enter the room, you see that the patient is on 4 LPM nasal cannula. He appears short of breath with tachypnea and shallow respirations. Chest excursion appears normal except in the RLL. Vocal fremitus is also absent in the RLL. Percussion reveals dullness in the RLL.

  20. Case Study A 90 year old male is s/p CVA and has been hospitalized for two weeks. He has begun spiking a temp (101 f). Physical exam reveals an emaciated patient with audible gurgling, rapid shallow respirations, and O2 at 6 LPM via simple mask. There is also a suction machine set up for N-T suctioning. Vocal fremitus is increased in both bases and the trachea is midline.

More Related