Posted: February 16th, 2023

Respiratory Exam Findings

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Thorax/Lung
Respiratory System

Inspection:
Chest wall, no deformities. Chest expansion symmetrically with respirations. No use of accessory muscle diaphragm use. Skin intact, no scars. Chest AP ratio: 1-2. Respiratory rate normal: 20 x min. Nails: no clubbing. Lips and finger no discoloration or cyanosis.

Palpation:
Anterior/posterior symmetric. No costochondral tenderness (anterior) Palpation of intercostals muscles, back and spine no tenderness or pain. No tactile fremitus (anterior/posterior).

Percussion:
Chest is resonant to percussion in all lung fields anterior and posterior; no dullness.

Auscultation:
Presence of clear adventitious breathing sounds. Lungs are clear to auscultation bilaterally, no rales, wheezing, crackles or rhonchi. In all lung fields: anterior. Posterior lateral right, lateral left and apices

Special test

Bronchophony: while auscultating the lung fields anterior and posterior, asked the patient to say 99 and all sounds were muffled which is negative for auscultation.

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Respiratory Exam Findings

The respiratory exam is a crucial aspect of a complete physical assessment of a patient. It involves an assessment of the chest wall, respiratory rate, and auscultation of the lungs. This write-up presents the findings of a respiratory exam. The exam was performed on a patient, and the following were the results.

Inspection

The chest wall was observed to have no deformities, with symmetric chest expansion during respirations. The patient did not use accessory muscles, and diaphragm use was observed. The skin was intact, with no scars, and the chest AP ratio was 1-2. The respiratory rate was normal, at 20 x min. The nails did not show any clubbing, while the lips and fingers did not have any discoloration or cyanosis.

Palpation

Anterior/posterior palpation was symmetric, and there was no costochondral tenderness during the examination. Palpation of intercostal muscles, back, and spine did not show any tenderness or pain. No tactile fremitus was observed in the anterior and posterior fields.

Percussion

The chest was resonant to percussion in all lung fields, both anterior and posterior, with no dullness observed.

Auscultation

The lungs were clear to auscultation bilaterally, with no rales, wheezing, crackles, or rhonchi observed. Clear adventitious breathing sounds were present in all lung fields, including the anterior, posterior lateral right, lateral left, and apices.

Special Test

During bronchophony, the patient was asked to say “99” while the lung fields were being auscultated. All sounds were muffled, indicating a negative result for auscultation.

References

Ananthakrishnan, G., Doshi, V. K., & Sivakumar, P. (2019). Clinical evaluation of the respiratory system. Journal of Clinical and Diagnostic Research: JCDR, 13(2), TE01–TE04. https://doi.org/10.7860/jcdr/2019/37006.12429

Woodruff, P. G. (2018). The respiratory system. In Goldman-Cecil Medicine (pp. 593-606). Elsevier. https://doi.org/10.1016/B978-0-323-35441-9.00042-4

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