Introduction to Respiratory Exam
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The article provides a brief overview of the respiratory examination. For a detailed walk-through please see the Respiratory Exam article.

  • Wash hands
  • Check patient name/DOB/hospital number
  • Introduce- My name is…”
  • Consent
  • “Is it ok if I have a look and feel of your head, neck, chest and hands?”
  • Chaperone
  • Confidentiality
  • Position – 45
  • Exposure – Chest
  • General: Comfortable at rest? Look around bedside for Oxygen, Nebulisers, Medication
  • Hands: Clubbing, Tar staining, Peripheral cyanosis, Flapping tremor, Pulse- character &rate
  • Mouth: Central cyanosis
  • Neck: JVP, Lymph Nodes
  • Chest: Scars, Deformities, Use of accessory muscles, Resp rate
  • Tracheal Deviation
    • Warn the patient this may be uncomfortable.
    • Best Technique:Single finger in sternal notch
  • Chest Expansion 
  • Vocal Fremitus is rarely helpful
  • Chest: Start at the apices above the clavicle, include the 3 lung zones (Upper/ Mid/ Lower) and the axilla
  • Compare right to left
  • Upper/ Mid/ Lower Zones
  • Normal sounds should be vesicular
  • Listen for added sounds eg. Wheezes, crackles, rubs.
  • Assess Vocal Resonance
Auscultation of the chest
Auscultation of the chest. This patient still has his T-shirt on. Do NOT do this in your OSCE!
  • Repeat Inspection/ Palpation/ Percussion / Auscultation on the patients back
  • At the end check the patients leg and sacrum for peripheral oedema
  • “To complete my examination I would like to request further investigations including full bloods/CXR/PEFR/Spirometry/Lung function tests” Adapt this appropriately to the patient you are examining.
  • Thank patient
  • Cover up and check comfortable

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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