Short summary points of inspection of chest

1. Examination of Chest
Inspection - Short points

2. Posture
• Sitting posture

3. Shapes of Chest
• Kyphoscoliosis
• Pectus excavatum
• Pectus carinatum
• Ankylosing spondylitis
• Gynecomastia
• Surgical scars
• Any other defect or prominence(vein,nevi)

4. Patterns/Types of Respiration
• Tachypnea – uniform rapid shallow breathing
• Kussmaul’s – relentless rapid deep breathing
• Cheyne-Stokes – cyclical waxing and wanning depth with regular apnea
• Biot’s breathing – totally irregular depth and apnea peroids
• Respiratory alternans – rapid shallow breathing,abdominal paradoxical motion,
alternation between rib cage and abdominal breathing

5. Schematic drawing of patterns of Breathing

6. Clinical Tip
• Hoover’s Sign
Paradoxical inward displacement of costal margin at end of inspiration or
throughout inspiration.
• Hoover's sign is a sign of obstructive airway disease.
• It's a paradoxical inward movement of the lower rib cage during inspiration,
instead of outward as is normal.
• It's caused by a change in the dynamics of diaphragmatic contraction due to
hyperinflation
• Resulting in traction on the rib margins by the flattened diaphragm.