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Chest Physical Examination: Paltep, Rashell Anne C. Family Medicine PGI September, 2020

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Rash Paltep

This document provides instructions for performing a physical examination of the chest. It describes observing the patient's general appearance and vital signs. It then gives directions for inspecting, palpating, percussing, and auscultating different areas of the chest. The examination includes assessing the apex beat, breath sounds, heart sounds, and checking for edema. It emphasizes communicating with the patient and maintaining cleanliness.

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Chest Physical Examination: Paltep, Rashell Anne C. Family Medicine PGI September, 2020

Uploaded by

Rash Paltep
30 views23 pages
This document provides instructions for performing a physical examination of the chest. It describes observing the patient's general appearance and vital signs. It then gives directions for inspecting, palpating, percussing, and auscultating different areas of the chest. The examination includes assessing the apex beat, breath sounds, heart sounds, and checking for edema. It emphasizes communicating with the patient and maintaining cleanliness.

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physical examination

Original Title

CHEST

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This document provides instructions for performing a physical examination of the chest. It describes observing the patient's general appearance and vital signs. It then gives directions for inspecting, palpating, percussing, and auscultating different areas of the chest. The examination includes assessing the apex beat, breath sounds, heart sounds, and checking for edema. It emphasizes communicating with the patient and maintaining cleanliness.

Copyright:

© All Rights Reserved
Download as PPTX, PDF, TXT or read online from Scribd
Download as pptx, pdf, or txt
30 views23 pages

Chest Physical Examination: Paltep, Rashell Anne C. Family Medicine PGI September, 2020

Uploaded by

Rash Paltep
This document provides instructions for performing a physical examination of the chest. It describes observing the patient's general appearance and vital signs. It then gives directions for inspecting, palpating, percussing, and auscultating different areas of the chest. The examination includes assessing the apex beat, breath sounds, heart sounds, and checking for edema. It emphasizes communicating with the patient and maintaining cleanliness.

Copyright:

© All Rights Reserved
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CHEST

PHYSICAL EXAMINATION
Paltep, Rashell Anne C.
Family Medicine PGI September, 2020
Introduction
• Introduce yourself
• Confirm the patient’s name and date of birth
• Briefly explain what the examination
• Wash your hands
general observation
• Observe hands and note for:
– Color
– Tar staining
– Skin changes
– Joint swelling
– Finger clubbing
– Fine tremors
general observation
• Capillary refill time (CRT)
- Apply five seconds of
pressure to the distal
phalanx of one of a
patient’s fingers and then
release.
general observation
• Palpate the brachial pulse
general observation
• Collapsing pulse
– forceful pulse that
rapidly increases and
subsequently collapses.
– It is also sometimes
referred to as a ‘water
hammer pulse’.
general observation
• Observe hands and note for:
– Peripheral pulses
– temperature
Measure the JVP
• Position the patient in a semi-recumbent position (at
45°).
Inspection of the chest
• Scars
• Chest wall deformities
– Asymmetry
– Pectus excavatum
– Pectus carinatum
– Hyperexpansion (a.k.a. “barrel chest”)
Palpation of the chest
• Palpate the apex beat
– Palpate the apex beat with your fingers placed
horizontally across the chest
– typically located in the 5th intercostal space in
the midclavicular line
Palpation of the chest
• Assess chest expansion
Palpation of the chest
• Palpate the carotid pulse
Palpation of the chest
Heaves
• precordial impulse that can be palpated.
Thrills
• palpable vibration caused by turbulent
blood flow through a heart valve
Palpation of the chest
Valve locations

• Mitral valve:
• 5th intercostal space in the midclavicular line.

• Tricuspid valve:
• 4th or 5th intercostal space at the lower left sternal edge.
Palpation of the chest
• Pulmonary valve:
• 2nd intercostal space at the left sternal edge.

• Aortic valve:
• 2nd intercostal space at the right sternal edge.
Percussion of the chest
Areas to percuss:
• Supraclavicular region
• Infraclavicular region
• Chest wall
• Axilla
Auscultation of the chest
• Assess the quality and volume of breath sounds and
note any added sounds.
Auscultation of the chest
Assess vocal resonance
• Ask the patient to say “99” repeatedly at the same
volume and in the same tone.
• Auscultate the four heart valves

• The bell of the stethoscope is more effective at


detecting low-frequency sounds

• The diaphragm of the stethoscope is more


effective at detecting high-frequency sounds
• Assess for evidence of pitting sacral and
pedal edema
• Assess the posterior chest including
inspection, chest expansion, percussion, and
auscultation

• Ask them to fold their arms across their


chest so that their hands are touching the
opposite shoulder.
To complete the examination
• Explain to the patient that the examination is now
finished.
• Thank the patient for their time.
• Wash your hands.
THANK YOU!!!

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