1. ASSESSMENT OF
RESPIRATORY SYSTEM

2. RESPIRATORY SYMPTOMS
 Chest pain
 Dyspnoea
 Wheeze
 Cough
 hemoptysis

3. Chest pain
 QUESTIONS TO ASK
 SITE
 NATURE OR QUALITY
 INTENSITY
 RADIATION
 DURATION
 ONSET
 RELIEVING AND AGGRAVATING
FACTORS
 ASSOCIATED MANIFESTATIONS

4. CAUSES
 CARDIOVASCULAR
 Angina
 MI
 PERCARDITIS
 DISSECTING AORTIC
ANEURYSM

5. PULMONARY
 TRACHEO BRONCHITIS
 PLEURAL
 PNEUMONIA, PE,NEOPLASM

6. GI
 REFLUX ESOPHAGITIS
 DIFFUSE ESOPHAGEAL
SPASM

 OTHER CAUSES
 CHEST WALL PAIN
 ANXIETY

7. DYSPNEA
 NON PAINFUL
UNCOMFORTABLE
AWARENESS OF BRETHING

8. QUESTIONS
 ONSET sudden or gradual
 Occurs on rest or exertion
 Interefere with daily activities
 Has dysnea altered the life style of
patient
 Timing and setting of dysnea
 Associated symptoms
 Relieving and aggravating factors

9. CAUSES
 LVF
 CHRONIC BRONCHITIS
 COPD
 ASTHMA
 ILD
 PNEUMONIA
 PNEUMOTHORAX
 ACUTE PE
 ANXIETY

10. COUGH
 REFLEX RESPONSE TO
STIMULI THAT IRRITATES
RECEPTORS IN LARYNX
,TRACHEA, AND LARGE
BRONCHI

11. QUESTIONS
 SINCE WHEN
 ONSET
 OCCURS AT WHAT TIME OF
DAY
 INTENSITY
 AGGRAVATING OR
RELIEVING FACTORS
 DRY OR PRODUCTIVE

12. SPUTUM
 AMOUNT
 COLOUR
 ODOUR
 CONSISTENCY
 BLOOD STREAKED

13. HEMOPTYSIS
 COUGHING UP BLOOD IN
SPUTUM IS HEMOPTYSIS

14. QUESTIONS
 SINCE WHEN?
 PRECEDED WITH COUGH ?
 QUANTIFY
 COLOUR OF BLOOD FRESH
OR ALTERED
 SETTING AND ACTIVITY
 ASSOCIATED SYMTOMS

15. DIFFERENTIATE FROM
HEMETEMESIS
 PRECEDED WITH NAUSEA
 ASSOCIATEED GI SYMPTOMS
 FOOD PARTICLES IN
VOMITUS
 ACIDIC PH

16. CAUSES
 LARYNGITIS
 TRACHEOBRONCHITIS
 PNEUMONIA
 POST NASAL DRIP
 CHRONIC BRONCHITIS
 BRONCHIECTASIS
 TB
 LUNG ABCESS

17. CONT…..
 ASTHMA
 GERD
 CA
 LVF
 MS
 PE
 INHALATION OF FUMES
PARTICLES CHEMICLES OR
GASES

18. CHEST CONTOUR AND
SYMMMETRY
 NORMALLLY LATERAL
DIAMETER IS MORE THAN AP
DIAMETER

19. DEFORMITIES
 BARREL
 FLAIL
 FUNNEL
 PIGEON
 KYPHOSCOLIOSIS

20. RESPIRATORY RATE
 14 TO 20 BREATHS PER
MINUTE
 THORACO ABDOMINAL IN
FEMALES ABDOMEN
PROTRUDES OUT DURING
INSPIRATION
 ABDOMENOTHORACIC IN
MALES

21. TACTILE FREMITUS
 WHEN SOUND WAVES
TRAVEL THRU
BRONCHOPULMONARY TREE
THERE IS PALPABLE
VIBRATIONS TRNSMITTED
THRU CHEST WALL

22. HOW TO CHECK?
 PLACE ULNAR BORDER OF
YOUR HAND ON THE CHEST
WHILE ASKING PT TO SPEAK
NINTYNINE.
 COMP;ARE BOTH SIDES
ANTERIORLY AND
POSTERIORLY.

23. CAUSES OF DECREASED
FREMITUS
 WHEN TRANSMISSION OF
 VIBRATION FROM LARYNX TO
THE SURFACE OF THE CHEST IS
IMPEDED.
 OBSTRUCTED BRONCHUS
 COPD
 PLEURAL EFFUSION
 PLEURAL THICKENING
 PNEUMOTHORAX
 INFILTRATING TUMOUR

24. CHEST EXPANSION
 5 TO 7 CM
 CAUSES OF UNILATERAL
REDUCED CHEST
EXPANSION
 FIBROSIS
 EFFUSION
 PNEUMONIA
 BRONCHIAL OBSTRUCTION

25. PERCUSSION
 SETS THE CHEST WALL AND
UNDERLYING TISSUR IONTO
MOTION PRODUCING
AUDIBLE SOND AND
PALPABLE VIBRATION
 PENETRATES ONLY 5 TO 7
CM INTO THE CHEST

26. PERCUSSION NOTES
 STONY DULL
 DULL
 RESONANT
 HYPERRESONANT
 TYMPANITIC

27. CAUSES
 DULLNESS LOBAR PNEUMONIA
 STONY DULL ,PLEURAL
EFFUSION
,HEMOTHORAX,EMPYEMA.
 HYPER RESONANCE ,
PNEUMOTHORAX AIR
CONTAINING BULLA
 TYPANITIC GASTRIC AIR BUBBLE

28. DIAPHRAGMATIC
EXCURSION
 DESCENT OF DIAPHRAGM
CHECKED THRU
PERCUSSION
 NORMALLY WITH FULL
INSPIRATION 5 TO 6 CM.

29. AUSCULTATION
 INTENSITY
 TYPE
 ADDED
 VOCAL RESONANANCE

30. TYPES OF BREATH
SOUNDS
 VESICULAR
 BRONCHO VESICULAR
 BRONCHIAL AS IN
PNEUMONIA,COLLASE WITH
PATENT
BRONCHUS,CAVITATION
UPPER PART OF PLEURAL
EFFUSION.

31. ADDED SOUNDS
 CRACKLES FINE AND
COARSE
 WHEEZES
 RONCHI
 PLEURAL RUB

32. CRACKLES
 WHEN DEFLATED SMALL
AIRWAYS OPEN UP DURING
INSPIRATION.
 ILD,CCF.
 AIR BUBBLES FLOWING
THRU SECRETIONSCHRONIC
BRONCHITIS.

33. WHEEZES
 WHEN AIRFLOW THRU
NARROIWED BRONCHI
WHISTLING SOUNDS PRODUCED.
 ASTHMA, COPD,CCF.
 LOALISED WHEEZE SIGNIFIES
PARTIOAL OBSTRUCTION OF
BRONCHUS BY TUMOUR OR
FOREIGN BODY

34. STRIDOR
 MUSICAL SOUND ENTIRELY
INSPIRATORY.
 OBSTRUCTION OF LARYNX
AND TRACHEA

35. PLEURAL RUB
 WHEN ROUGHENED
PLEURAL SURFACES RUB
AGAINST EACH OTHER.

36. TRNSMITTED SOUNDS.
 BRONCHOPHONY LODER AND
CLEARER VOICE SOUNDS
 EGOPHONY QUALITY OF
SOUNDS TURNED TP NASAL “EE”
TO “AY”
 WHISPERED PECTORILOQUY
LODER CLEARE WHISPERED
SOUNDS.
 ALL ABOVE ARE FOUND IN
CONSOLIDATION

37. THANK YOU