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Published by: hung71289 on 26 November 2010  |   0       | Report post

Respi Examination collection
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Respi Examination collection
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In medicine, the respiratory examination is performed as part of a physical examination, or when a patient presents with a respiratory problem (dyspnea (shortness of breath), cough, chest pain) or a history that suggests a pathology of the lungs.
Position – patient should sit upright on the examination table. The patients hands should remain at their sides. When the back is examined the patient is usually asked to move their arms forward (hug themself position) so that the scapulae are not in the way of examining the upper lung fields. as many physicians around world request
Lighting – adjusted so that it is ideal. Draping – the chest should be fully exposed. Exposure time should be minimized.
The basic steps of the examination can be remembered with the mnemonic IPPA:
* Inspection
* Palpation
* Percussion
* Auscultation
Chest wall deformities
* Kyphosis – curvature of the spine – anterior-posterior
* Scoliosis – curvature of the spine – lateral
* Barrel chest – chest wall increased anterior-posterior; normal in children; typical of hyperinflation seen in COPD
* Pectus excavatum – sternum sunken into the chest
* Pectus carinatum – sternum protruding from the chest
Signs of respiratory distress
* Cyanosis – person turns blue
* Pursed-lip breathing – seen in COPD (used to increase end expiratory pressure)
* Accessory muscle use (scalene muscles)
* Diaphragmatic paradox – the diaphragm moves opposite of the normal direction on inspiration; suspect flail segment in trauma
* Intercostal indrawing
* Movement of chest-chest movement decreases on the affected side
* Jugular venous pulse-indicates right heart failure.

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