Respiratory

system
examination

Characteristics signs of COPD Cyanosis Characters of the cough Stridor Hoarseness Hands Tachycardia & pulsus paradoxus ( Flapping tremor (asterixis) Face Trachea Chest
drop in BP during inspiration by >
10 mmHg)
Use of accessory muscles of respiration Pursed-lip breathing Leaning forward with their hands on their Tracheal tug Central cyanosis Peripheral cyanosis Lack of the usual explosive beginning muffled, wheezy, ineffective cough A very loose productive cough A dry, irritating cough Barking cough Obstruction of the larynx/trachea Loudest on inspiration Recurrent laryngeal nerve palsy associated Laryngeal carcinoma Laryngitis Use of inhaled corticosteroids Clubbing Tar Staining Wasting and weakness Severe CO2 retention Nose Mouth Sinusis Red, leathery, wrinkled skin of the smoker Facial plethora/cyanosis Eyes Slightly to the right Inspection Palpation Percussion Auscultation
knees with left-sided carcinoma of the lung

VIP signs of sever asthma

Elevation of the shoulders with inspiration to Contraction of abdominal muscles in In severe asthma also (esp. in children) Downward displacement of the trachea Tongue inspection Bovine cough Obstructive pulmonary disease Bronchiectasis Chronic bronchitis Pneumonia Chest infection Asthma Carcinoma of the bronchus Interstitial lung disease ACE inhibitors Upper air way DOES NOT occurs as a result of COPD a peripheral lung tumour of a lower trunk of Polyps Engorged turbinates Deviated septum Evidence of an URI Crowding of pharynx Broken/rotten tooth stump Tenderness over the sinus on palpation Superior vena caval obstruction Horner’s syndrome Normal Shape & symmetry Scars Movements of the chest wall Percussion over a solid structure, such as Percussion over a fluid-filled area, such as a Normal Percussion over the normal lung produces a Liver dullness Cardiac dullness
increase chest expansion expiration Compresses the abdomen and pushes the the T1 nerve root results in wasting of the the liver or a consolidated or collapsed area pleural effusion resonant note and percussion over hollow
diaphragm upwards small muscles of the hand and weakness of of lung structures, such as the bowel or a
Vocal cord paralysis Pharynx Larynx Pertussis infection finger abduction. Asthma Various allergic conditions Nasal obstruction Sleep apnoea Lung abscess Sinusitis (a constricted pupil, partial ptosis and loss of Increase in AP diameter compared to the Funnel chest Pigeon chest Assessment of expansion of the upper lobes Reduced chest wall movement on one side Bilateral reduction of chest wall movement paradoxical inward motion of the abdomen Resonant pneumothorax Normally, the upper level of liver dullness is usually present on the left side of the chest
Obstructed airways sweating) lateral diameter during inspiration when the patient is supine Stony dull the sixth intercostal space in the right may be decreased in emphysema or asthma.
Dull note midclavicular line. If the chest is resonant
Localized lung fibrosis Consolidation Collapse Pleural effusion Pneumothorax COPD Diffuse interstitial lung disease Hyperresonant below this level, it is a sign of hyperinflation,
Apical lung carcinoma Diaphragmatic paralysis usually due to emphysema or asthma.

Barrel chest

a localised prominence (an outward bowing

Severe asthma & emphysema of the sternum and costal cartilages)