Scribd Logo
Upload

Welcome to Scribd!

    • 107 views

    Assessing The Respiratory System (Thorax & Lungs)

    Uploaded by

    JENNA ELOISA UY
    This document provides guidance on assessing the respiratory system by examining the structure and function of the thorax and lungs. It outlines the normal findings and deviations from normal for inspection, palpation, percussion, and auscultation of the chest. Key assessment techniques include examining symmetry and expansion of the chest wall, palpating for tactile fremitus, and auscultating breath sounds and vocal fremitus. Abnormal findings may indicate conditions affecting the lungs, chest wall, or pleural spaces.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Assessing The Respiratory System (Thorax & Lungs)

    Uploaded by

    JENNA ELOISA UY
    107 views3 pages
    This document provides guidance on assessing the respiratory system by examining the structure and function of the thorax and lungs. It outlines the normal findings and deviations from normal for inspection, palpation, percussion, and auscultation of the chest. Key assessment techniques include examining symmetry and expansion of the chest wall, palpating for tactile fremitus, and auscultating breath sounds and vocal fremitus. Abnormal findings may indicate conditions affecting the lungs, chest wall, or pleural spaces.

    Original Description:

    thorax and lungs

    Original Title

    Thorax and Lungs

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides guidance on assessing the respiratory system by examining the structure and function of the thorax and lungs. It outlines the normal findings and deviations from normal for inspection, palpation, percussion, and auscultation of the chest. Key assessment techniques include examining symmetry and expansion of the chest wall, palpating for tactile fremitus, and auscultating breath sounds and vocal fremitus. Abnormal findings may indicate conditions affecting the lungs, chest wall, or pleural spaces.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    107 views3 pages

    Assessing The Respiratory System (Thorax & Lungs)

    Uploaded by

    JENNA ELOISA UY
    This document provides guidance on assessing the respiratory system by examining the structure and function of the thorax and lungs. It outlines the normal findings and deviations from normal for inspection, palpation, percussion, and auscultation of the chest. Key assessment techniques include examining symmetry and expansion of the chest wall, palpating for tactile fremitus, and auscultating breath sounds and vocal fremitus. Abnormal findings may indicate conditions affecting the lungs, chest wall, or pleural spaces.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    ASSESSING THE RESPIRATORY SYSTEM (Thorax & Lungs)

    ASSESSMENT NORMAL FINDINGS DEVIATION FROM NORMAL


    1. Examine the back of the chest first, The diameter of the thorax should be Pectus Carinatum
    comparing one side with the other. Then greater from side to side than from front Pectus Excavatum
    examine the front of the chest using the to back. Thoracic Kyphoscoliosis
    same sequence. Observe the chest from Barrel Chest
    the side as well.

    2. Inspect the chest wall symmetry. Respiratory pattern must be even, Frequent use of accessory muscles
    Note masses or scars that indicate coordinated and regular with occasional may indicate a respiratory breathing,
    trauma or surgery. Respiratory sighs. particularly when the patient purses his
    Rate and pattern: Count the RR. lips and flares his nostrils with
    breathing.
    Accessory muscle use: Observe the
    diaphragm and intercostal muscles with
    breathing.

    PALPATION
    3. Palpate the chest wall Should feel smooth, warm and dry. Gentle palpation causes pain.
    Gentle palpation shouldn’t cause
    the patient pain.

    4. Palpate for tactile fremitus Both lungs have equal vibrations. Vibrations that feel more intense on one
    (palpable vibrations caused by the side than the other indicate tissue
    transmission of air through the consolidation on that side (denser or
    bronchopulmonary system.) inflamed lung tissue).
    a. Ask patient to fold arms Less intense vibrations may
    across chest. indicate air or fluid in the pleural
    b. Lightly place your open palms spaces or a decrease in lung tissue
    on both sides of the patient’s density
    back w/o touching his back w/
    your fingers.
    c. Ask the patient to repeat the
    phrase “ninety-nine” loud
    enough to produce palpable
    vibrations.
    d. Palpate the front chest using
    the same hand positions

    5. Evaluating chest wall & These should separate simultaneously


    symmetry and expansion and equally to a distance several cm
    a. Place your hands in front of away from the sternum.
    the chest wall w/ your thumbs
    touching each other at the 2nd
    ICS. As the patient inhales
    deeply, watch your thumbs.
    Repeat the measurement at
    the 5th ICS.
    PERCUSSION Resonance Hyper resonance
    1. Percussing the chest wall
    a. Place your non-dominant hand
    over the chest wall, pressing
    firmly with your middle finger.
    b. Position your dominant hand
    over your other hand
    c. By flexing the wrist of your
    dominant hand, tap the middle
    finger of your non dominant
    hand with the middle finger of
    your dominant hand

    AUSCULTATION  Bronchial- loud and high-pitched Abnormal breath sounds are


    1. During auscultation, the client sounds with a hollow quality heard characterized by decreased or absent
    should be instructed to breathe longer on expiration sounds.
    only through the mouth than inspiration from air moving through  Crackles- an interrupted fine
    because mouth breathing the trachea crackle (dry, high-pitched crackling,
    decreases air turbulence that  Bronchovesicular- medium- popping sound of short duration) that
    could interfere with an pitched and blowing sounds heard sounds like a piece of hair being
    accurate assessment. equally on inspiration & expiration rolled between the fingers in front of
    a. Press the diaphragm of the from air moving through the large the ear or a coarse crackle (moist,
    stethoscope firmly against the airways, posteriorly between the low-pitched crackling, gurgling sound
    skin. scapula & anteriorly over of long duration) that sounds like
    b. Listen to a full inspiration and bronchioles lateral to the sternum water going down the drain after the
    full expiration at each site in the at the 1ST and 2ND ICS plug has been pulled on a full tub of
    sequence shown.  Vesicular - soft, breezy, and low- water
    c. .Compare sound variations from pitched sounds heard longer on  Rhonchi- heard predominantly on
    one side to the other inspiration than expiration that expiration over the trachea and
    d. Document result from air moving through the bronchi as a continuous, low-
    smaller airways over the lung’s pitched musical sound
    periphery, with the exception of  Wheezes- heard predominantly
    the scapular area on expiration all over the lungs as
    a continuous sonorous wheeze
    (low-pitched snoring) or sibilant
    wheeze (high-pitched musical
    sound)
     Pleural Friction Rub- heard on
    either inspiration or expiration over
    the anterior lateral lungs as a
    continuous creaking, grating
    sound
     Stridor- heard predominantly on
    inspiration as a continuous
    crowing sound

    2. Auscultating for vocal


    fremitus

    Bronchophony- Ask the Bronchophony- the sound of “ninety- If it sounds clear through the
    patient to say "99" several nine” will sound very faint and muffled stethoscope, there is probably
    times while auscultating the consolidation of the lung
    chest walls. and Bronchophony is present.
    Egophony- Ask the patient to Egophony- Over healthy lung areas, the Over consolidated lung areas, the
    say "Eeee" several times and sound is understandable as an "E". sound is heard as an "A" (aaay).
    auscultate the chest walls.

    Whispered Pectoriloquy- Ask


    the patient to whisper "1-2-3" Whispered Pectoriloquy- spoken
    several times while sounds of a whispered volume by the The lung area is abnormal if the "1-2-3"
    auscultating across the chest patient would not be heard by the sound is understood. This is the
    walls. clinician auscultating a lung field with a abnormal '1-2-3'.
    stethoscope.

    You might also like