Lung Examination

by Jeremy Brown, PhD

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    There’s a good question as to why bother examining patients nowadays, now that we have such good investigations available. There are several answers to that question. The first being most obviously is that actually the x-rays or the investigations you want to do may not be available. And that would happen if somebody presents with acute respiratory distress. You don’t have time to get the x-rays, the echocardiogram, the CT scan before you actually have to treat the patient. So clinical skills are essential in that circumstance. In addition, you may not be considering doing the test that is required until you examine the patient and identify an unexpected finding that might suggest something that requires a specific investigation. So, for example, you might hear a pleural rub and then start thinking the patient may have a pulmonary embolus and ask for a CT pulmonary angiogram which, previously, you weren’t considering. And in addition there are signs that actually are not identified by investigations but are identified by examination which do have very important implications for the patient. And the most obvious one of that is clubbing. Finger clubbing indicates there’s a serious medical problem going on with the patient and there are no tests that we do which identify that. It’s purely on examination. So what is the process of examination? Well, you’ve done your history and then you move on to examine the patient. And the idea of doing the examination is so that you can identify signs that might confirm the suspicions that you have of what diagnosis might explain the patient’s symptoms. Not only that. You’re also looking for signs which might not fit with the diagnosis you’re thinking of and change your mind about what is going on. So, for example, we may have a...

    About the Lecture

    The lecture Lung Examination by Jeremy Brown, PhD is from the course Introduction to the Respiratory System. It contains the following chapters:

    • Lung Examination
    • General observation of the patient
    • Clubbing, trachea and expansion
    • Lung surface and breath sounds
    • Signs for common clinical presentations
    • Fixed airways obstruction

    Included Quiz Questions

    1. Kussmauls and diabetic ketoacidosis
    2. Cheyne-Stokes and an exacerbation of asthma
    3. Stridor and severe COPD
    4. Paradoxical abdominal movements and pulmonary fibrosis
    1. Clubbing and pneumonia
    2. Clubbing and lung cancer
    3. Deviated trachea to the affected side in lobar collapse
    4. Deviated trachea away from the affected side in a pneumothorax
    1. A right sided pneumothorax
    2. Paralysed right phrenic nerve
    3. Right pleural effusion
    4. Collapse of the right lower lobe
    1. Extensive inspiratory crepitations
    2. Prolonged expiration phase
    3. Reduced expansion of the chest bilaterally
    4. Increased anterior-posterior diameter of the chest

    Author of lecture Lung Examination

     Jeremy Brown, PhD

    Jeremy Brown, PhD

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