Chest Exam | The University Of Western Ontario

University:
The University Of Western Ontario
Course:
MED 5161 | Principle of Medicine
Academic year:

2025
Views:

22

Pages:

2
Author:

Kyuwon J.

Chest exam ● 3 pattern diagnosis ○ Fluid ○ Solid lung ○ Air in pleural space ● Pleural effusion ○ Fluid in pleural space ○ Fluid collects independently in pleural cavity ○ Significant for costodiaphragmatic recess ■ Inspection ● Reduction of chest expansion ● Larger effusion ● Especially on the affected side ■ Palpation ● Decrease in tactile fremitus ■ Percussion ● Stony fullness ■ Auscultation ● Decrease or absent in breathing sound by fluid ■ Voice sound ● Reduction by effusion ● Often bronchial breathing is just above fluid level ○ Blunted costophrenic angle on CXR ■ Meniscus sign ■ Larger effusions ● Consolidation ○ Pneumonia filling alveoli ○ Exudate ○ Airspace is filled with fluid or cells ■ Lung will become more solid ■ Airway could remain open ○ Palpation ■ Increase in tactile fremitus ■ Transmits better through solid ○ Percussion ■ Dull ■ Not stoney in most of the case ○ Ausculation ■ Bronchial breath sounds over consolidated area ○ Voice sound ■ Increase vocal response ● Bronchophony ● Egophony ○ E→A ○ Whispered pectoriloquy ■ Often crackles ● Inspiratory ○ Lobar may see air bronchograms on image