EXAMINATION OF RESPIRATORY SYSTEM Dr K V CHALAPATHI

EXAMINATION OF RESPIRATORY SYSTEM Dr K. V. CHALAPATHI RAO

HISTORY • Cough—dry or productive • If productive-----quantity, colour, nature, odour, haemoptysis, relation to posture, diurnal variation. • Breathlessness---- duration, grade, postural variation, diurnal variation, seasonal variation, • History of PND , or ORTHOPNEA • History of wheezing

• Chest pain-------site, duration, nature, relation with respiration aggravating & releiving factors. • H/O Fever • H/o allergies, swelling of feet, palpitations, seizures, surgery under general anesthesia

• Past history—hypertension, DM, TB, HIV, EXATHEMATOUS FEVERS, • Personal history—smoking, alcohol, drug addictions, • Treatment history.

GENERAL EXAMINATION • Built, nourishment, anemia, jaundice, cyanosis, clubbing, koilynochia, lymphadenopathy, pedal edema • Vitals –pulse, BP, temp, respirations-rate, regular , type of respiration

RESPIRATORY SYSTEM • • • INSPECTION---upper respiratory tract Trachea Shape of chest Apex beat Engorged veins, pulsations Scars, sinuses, swellings, bulgings

• Drooping of shoulder • Widening of intercostal spaces • Indrawing of intercostal spaces, crowding of ribs • Increased hollowness or fullness of supra and infra clavicular fosse • Movements of chest

PALPATION • • • TRACHEAL POSITION APICAL IMPULSE MOVEMENTS OF CHEST MEASUREMENTS—AP& TRANSVERSE DIAMETER, CHEST-INSPIRATION, EXPIRATION HEMI THORAX MEASUREMENT PALPATION OF INTER COSTAL SPACES VOCAL FREMITUS TENDERNESS, LOCAL RISE OF TEMP

PERCUSSION • • • • Direct percussion over clavicles Indirect percussion -Anteriorsupra clavicular KRONIGS ISTHMUS infraclavicular mammary infra mammary Lateral— axillary, infra axillary Posterior— supra scapular inter scapular infra scapular areas Liver dullness. Tidal percussion, Traube”s space

• Hydro pneumo thorax—S-straight line upper border • S-shifting dullness • S –succusion splash • Coin test above the fluid level.

AUSCULTATION • • Vocal resonance If increased –bronchophony whispering pectoriloquy aegophony in pleural effusion BREATH SOUNDS– intensity character-vesicular or bronchial Adventitious sounds— crepitations, rhonchi, pleural rub, post tussive crepitations. • Examination of other systems

• THANK YOU