General respiratory Ex
We will cover these points : 1- general look2- vital signs 3- both hands4- eyes5- nose6- mouth7- sinuses8- neck9- Lower limb edema
General look
• Consciousness• Oriented• Distressed• Lying flat• Audible wheezing or stridor• Connected to IV line or O2 mask• Lip pursing• Acting nasal alae• Using accessory muscle
A : apperance
B : body built
C : color
D : distressed
E : environment
Hands
1- NailClubbing, cyanosis, nicotine staining2-palmWarm, pallor3-DorsumMuscle wasting4-TremorFine, flapping
5- Eyes
Pallor, jaundice, sign of Horner syndrome
6- Nose
Acting nasal alae
7- Mouth
Central cyanosis in the tip of the tongue
Peripheral cyanosis in lip or fingers
Lip pursing
Chest
By inspection
Type of breathing, symmetry, scar, deformity like .
Pectus excavatum, pectus carinatum, barrel chest, Harrison sulcus
Prominent veins, intercostals retraction
back, kyphosclosis
By auscultation
1- Air entry ( Breathing sounds)
2- Type of breathing
3- Added sounds like wheezing and fine or coarse crepitations or pleural friction rub
4- Vocal resonance