Physical examination
of the chest(2)
郑翠霞
Auscultation
?Normal breath sound
? vesicular breath sound
? bronchial breath sound
? bronchovescicular breath sound
Abnormal breath sound
?Decreased or absent
?Increased alveolar breath
sound
J,
Lower breathing
J,
Exert your breathing
Adventitious sounds
Discontnuous
Contnuous
fine
coarse
wheezes
rhonchus
Dry/ rhonchi
Rale/ crackes
?moist rale( crackles)
? Rhonchi
? Vocal resonance
? pleural rubbing, crepitus
?Adventitious sound
Extra-pulmonary sign
?Cyanosis,
?Clubbing fingers,
?Paraneoplastic syndrones,
Central
peripheral
Lobe pneumonia
?Cough,chest pain,dyspnea
?Consolidation signs,
? pleural fremitus
?WBC??,
?lobel infiltration on chest film
Bronchial Asthma
?short of breath
?Over inflation
?wheeze,dyspnea
?EOS ?
?chest film and sputum changes
emphysema
?Increasing onset of exertional dyspnea
?Barrel chest,prolonged expiration,
decreased or diminution breath sound
?X-ray,over inflation,flatten diaphragm,
drip like heart,
?Respiration function,obstructive
abnormality with increased RV(>40%TLC)
Pleural Effusion
?Dullness Chest pain
?Short of breath
?Dullness on percussion
?Disappeared breathing sound
?Chest film
Pneumothorax
?Abrupt chest pain after inducing factor
?short of breath
?Tympani or hyperresonance on
percussion
?Chest wall inflation
?Absent/ decreased breathing sound
?Chest film
Subcutaneous emphysema
?Barral chest wall,decreased movemnt,
neck vein distension
?Hyperresonance
?Decreased breathing sound