M1 H&P: Thorax and Lungs

Devin Nickol, M.D.

I. Inspection

- Look at the shape of the thorax - symmetrical?

 

- Note respiratory rate

 

- Note respiratory rhythm and effort

 

II. Palpation

- Assess thoracic expansion

 

- Check for tactile vocal fremitus

 

- Is the trachea in the midline?

 

III. Percussion

- Percuss the lung fields anteriorly, posteriorly, and laterally

 

- Identify areas of:

     hyperresonance

     tympany

     resonance

     dullness

      flatness

 

- Measure diaphragmatic excursion

 

IV. Auscultation

- Use the stethoscope diaphragm

 

- Identify the type of breath sound

     vesicular

     bronchovesicular

     bronchial

     tracheal

 

- Recognize abnormal breath sounds

     rhonchi

     rales

     wheezes

 

- Check for egophony

 

- Check for whispered pectoriloquy