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physical
examination
THE THORAX AND LUNGS
Chest landmarks
Location of the anterior and posterior
ribs
Chest shape and size
• Inadultsthoraxisoval
• ItsAnterioposterior
diameterishalfits
transversediameter.
• Theoverallshapeof
thoraxiselliptical.
Assessmentincludes
Posteriorthorax
Anteriorthorax
Thorax and lungs
Techniques
Inspection
Palpation
Percussion
Auscultation
Equipments
Stethoscope
Skinmarker/pencil
Centimeterruler
Posterior thorax
• Inspectshapeand
symmetry
• Inspectspinalalignment
fordeformities
Deformities of chest
Posterior thorax
• Palpatetheposteriorthorax
• Palpate the posterior chest for
respiratory excursion (thoracic
expansion)
• Palpatethechestforvocal
(tactile)fremitus,thefaintly
perceptiblevibrationfelt
throughthechestwallwhen
theclientspeaks
Posterior thorax
Chestexpansion Tactilefremitus
• Percussthethorax
• Percuss for
diaphragmaticexcursion
(movementofthe
diaphragmduring
maximalinspirationand
expiration)
Posterior thorax
Posterior thorax
Diaphragmaticexcursion
Posterior thorax
• Auscultate the chest using
the flat disc diaphragm of
thestethoscope
Anterior thorax
• Inspectbreathingpatterns
• Insectthecostalangle
(angleformedbythe
intersectionofthecostal
margins <90degree)and
theangleatwhichtheribs
enterthespine (appx;45
degreeangle)
• Palpatetheanteriorchest
• Palpatetheanteriorchest
forrespiratoryexcursion
• Palpatethetactilefremitus
Anterior thorax
• Percusstheanteriorchest
systematically
Anterior thorax
• Auscultatethetrachea
• Auscultatetheanterior
thorax
Anterior thorax
Normal Breath sounds
Adventitious breath sounds
Adventitious breath sounds
THE CARDIOVASCULAR AND
PERIPHERAL VASCULAR
SYSTEMS
HEART
Techniques
•Inspection
•Palpation
•Auscultation
Equipments,
•Stethoscope
•Centimeterruler
Assessmentincludes,
•Heart
•Centralvessels
•Peripheralvascularsystem
Heart
HEART
Anatomicsitesoftheprecordium
HEART
• Simultaneouslyinspectandpalpatetheprecordiumforthe
presenceofabnormalpulsations,lifts,orheaves.
• Auscultatetheheartinallfouranatomicsites
HEART
Normal heart sounds
Normal heart sound
CENTRAL VESSELS
CAROTID ARTERIES
• Palpatethecarotidartery,usingextremecaution
• Auscultatethecarotidartery
JUGULAR VEINS
• Inspectthejugularveinfordistension
• If jugulardistensionispresent, assessthejugularvenous
pressure
• Peripheralpulses
• Peripheralveins
• Peripheralperfusion
–Buerger’stest(arterialadequacytest):Buerger'stestis
usedtoassesstheadequacyofthearterialsupplytotheleg.
–Capillaryrefilltest
PERIPHERAL VASCULAR SYSTEM
BREAST AND AXILLAE
BREAST AND AXILLAE
• Inspectthebreastsforsizesymmetryandcontourorshape
• Inspecttheskinofthebreast
• Inspecttheareola
• Inspectthenipple
• PalpatetheAxillary,subclavicular, supraclavicularlymph
nodes.
• Palpatethebreastformasses, tendernessandany
dischargesfromthenipples
physicalexaminationthoraxandlungs-171115065133.pptx
physicalexaminationthoraxandlungs-171115065133.pptx

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physicalexaminationthoraxandlungs-171115065133.pptx