Respiratory examination

My study for the day.......Respiratory examination from Clinical examination by Talley and O'Connor

• General inspection 
• Sputum mug contents (blood, pus etc)
• Type of cough
• Rate and depth of respiration, and breathing pattern at rest
• Accessory muscles of respiration 
• Hands
• Clubbing 
• cyanosis 
• Nicotine staining
• Wasting, weakness - finger abduction and adduction (lung cancer involving the brachial plexus)
• Wrist tenderness (hypertrophic pulmonary osteoarthropathy)
• Pulse (tachycardia; pulsus paradoxus)
• Flapping tremor (co2 narcosis)
• Face
• Eyes - Horner's syndrome (apical lung cancer)
• Mouth - central cyanosis 
• Voice - hoarseness (recurrent laryngeal nerve palsy)
• Chest posteriorly
• inspect 
• shape of chest and spine
• Scars
• Palpate
• Cervical lymph nodes 
• Expansion 
• Tactile femitus
• Percuss
• Supraclavicular region 
• Back
• Axillae
• Auscultate 
• Breath sounds
• Adventitious sounds
• Vocal resonance
• Chest anteriorly
• Inspect
• radiotherapy marks
• Other signs as noted above
• Palpate
• supraclavicular nodes
• Expansion 
• Tactile fremitus
• Percuss
• Auscultate
• Assessment of right heart failure