Respiratory system

Static inspection of the chest: the shape — normal (normosthenic, hypersthenic, asthenic), pathological (emphysematous, paralytic, funnel, foveated, pigeon, narrow, rachitic, kyphotic, scoliotic), asymmetry (increase or decrease one half of chest, local outpouching or retraction), position of shoulders (usual, sloping, horizontal), supraclavicular and infraclavicular fossae, Ludowici angle (levelling, expressed, moderate), course of ribs (horizontal, more vertical), intercostal spaces (without contour, with contour, wide, narrow), epigastric angle (right angles, obtuse angle, acute angle), position scapulae (closely fit to the chest, separated from the chest).

Dynamic inspection of the chest: two sides of the chest are seen to move with respiration (comparison of movement on the too sides during breathing) (to an equal extent, lagging of one side), retraction intercostal space (symmetric, more expressed — in what place), mode of breathing (thoracic, abdominal, mixed), respiratory frequency – the number of breath in a full minute, depth of breathing (deep, superficial), rhythm (rhythmical, pathological Cheyne-Stokes breathing, Kussmaul's breathing, Biot's breathing, Grokko), dyspnoea (expiratory, inspiratory, mixed), participation of auxiliary muscles in breathing.

Palpation: rigidity, floppiness of a chest, sites of atrophy, tenderness at palpation of muscles (where exactly, amplification at bending of body in the lesion or the healthy side), bones (ribs, breast bone (sternum), vertebrae), painful points on intercostal space (what under the account, on the right, at the left); vocal fremitus: normal, amplified, weakened, it is not auscultate (to specify localization)

Topographical percussion lungs lower borders lungs

Lines Right lung Left lung

Parasternal

Mid clavicular

Axillary anterior

Mid-axillary

Axillary posterior

Scapularis

Paravertebral

Range of movement of the lower pulmonary body (diaphragmatic movement) (sm)
Lines	Right lung	Left lung
Mid clavicular
Mid-axillary
Scapularis

Height of position upper lobes:

in front — on ….. cm on the right and on ……. cm

at the left is higher clavicle, behind — on …. And ….. cm

is accordingly higher than spinous process of 7-th vertebra cervical.

Width of fields Krenigs, on the right — cm, at the left — cm.

Space Traube:

length — cm

height — cm

the form — semilunar, changed (displacement, restriction etc.).

Respiratory movements of the lower ribs.

Comparative percussion of lungs

Character percussion sound (note, resonance) on symmetric sites of a chest: clear (resonant), dullish (impaired), dull, clear resonance with tympanic resonance, hyperresonant (tympanic), vesiculotympanitic resonance (bandbox), bell, dull-tympanic (at presence of changes percussion a sound to specify topography — lines of an ribs, intercostal space).