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A2 respiration examination ((temp, BP, sputum pot, chest x-ray, CT,…
A2 respiration examination
head
eyes
face
mouth
hands
radial pulse
rate, rhythm
breathing rate
flapping tremor
flapping tremor, sweaty palm, bounding pulse
appearance
T1 muscle wasting, tar stain
nail, capillary refill
clubbing
temperature
neck
mass
JVP (hepatojugular)
height
normal: 3 + 5 = 8cm
zero point: sternal angle
5 cm: centre of R atrium
inspection/palpation
chest expansion
unilateral
bilateral
upper lobe: tracheal deviation
towards
collpase, fibrosis
away
massive pleural effusion, tension pneumothorax
lower lobe: apex beat displacement
towards
collapse, fibrosis
away
massive pleural effusion, tension pneumothorax
x palpable
COPD
percussion/auscultation
chest expansion
lymph nodes
percussion/auscultation
general
respiratory distress (accessory muscles)
obese, cachetic
conscious and alert
bedside
temp, BP
sputum pot
chest x-ray, CT
spirometry
peak flow meter
inspection
scar
chest drains
lobectomy
deformity
funnel chest: pectus excavatum
pigeon chest: pectus carinatum
harrison's sulcus
hyperinflated chest, barrel chest (AP diameter)