Resp. Exam

Question 1

Hands

Answer 1

• Tar Staining
• Compare yours fingers to theirs for peripheral cyanosis or anaemia
• Clubbing
• CO2 retention (Palmar warmth, pinkness, flapping tremors)

Question 2

Signs of clubbing?

Answer 2

• Loss of nail angle
• Nailbed fluctuation
• Increased nail curvature
• Increased soft tissue bulk

Question 3

Head?

Answer 3

Tongue & lips - Central cyanosis

Conjunctivae for pallor

Question 4

Neck

Answer 4

Tracheal deviation (with thumbs looped medially behind SCMs)
Cervical lymph nodes

Question 5

ORder of cervical lymph nodes?

Answer 5

• Supraclavicular
• Anterior cervical chain
• Submandibular
• Submental
• Pre/post auricular
• Occipital
• Post Cervical chain

Question 6

Back of chest?

Answer 6

Patient sat forward with arms folded on pillow

• Inspect
• Chest expansion
• Percussion
• Auscultation (including vocal resonance)

Question 7

What do you look for when percussing the chest?

Answer 7

• Hyper-resonance (e.g. emphysema or pneumothorax)
• Dull/impaired (reduced air due to consolidation, fibrosis, lung collapse or thickened pleura)
• Stony dullness (fluid due to pleural effusion)
• Upper border of liver dullness

Question 8

What do you look for when auscultating the chest?

Answer 8

• Is breathing vesicular or bronchial
• Loudness of sounds
• Added sounds? (crackles, wheezes or rubs)
• Are abnormalities expiratory or inspiratory?

Question 9

Front of chest?

Answer 9

Patient reclined at 45*

• Inspection
• Tracheal position
• Apex beat
• Chest Expansion
• Percussion (clavicles directly, heart will be dull)
• Auscultation incl vocal resonance