Thorax and Lung Assessment Techniques

Posterior Thorax and Lung Assessment

Performing an assessment of the posterior thorax and lungs using a stethoscope while ensuring patient privacy.

Respiratory Rate

Checking the number of breaths per minute; Normal: 12-20 breaths/min.

Respiratory Rhythm

Assessing the regularity of breathing; Normal: Regular rhythm.

Respiratory Depth

Evaluating the volume of air inhaled and exhaled; Normal: Even depth.

Accessory Muscle Use

Observing for the use of additional muscles during breathing; Normal: No accessory use.

Chest Inspection

Inspecting the posterior chest for shape, symmetry, lesions, or masses; Normal: Chest symmetrical, AP to lateral diameter 1:2, No lesions or masses.

Thoracic Expansion

Palpating for equal chest rise bilaterally; Normal: Equal chest rise bilaterally.

Tactile Fremitus

Palpating vibrations while the patient says 'ninety-nine'; Normal: Equal vibrations.

Percussion of Thorax

Percussing over the posterior thorax to assess underlying tissue; Normal: Resonant sounds over lung fields.

Auscultation of Lung Fields

Listening to all posterior lung fields, one full breath in each spot; Normal: Clear vesicular/bronchovesicular breath sounds.

Vocal Sounds Special Tests

Checking for egophony, bronchophony, and whispered pectoriloquy; Normal: Egophony: 'E' stays 'E', Bronchophony: '99' muffled, Whispered: '1-2-3' faint or not heard.

Inspect Skin and Mucosa

Inspecting skin and mucous membranes for pallor or cyanosis; Normal: Pink, warm, no pallor or cyanosis.

Inspect Precordium

Looking for lifts, heaves, or pulsations on the chest; Normal: No visible lifts/heaves, possible apical pulsation.

Palpate PMI

Palpating the apical impulse; Normal: 5th ICS, midclavicular line; soft, brief tap.

Palpate Carotids

Palpating carotid arteries one at a time to avoid vagal stimulation; Normal: 2+ amplitude, regular, equal.

Auscultate Heart Sounds

Listening to heart sounds over 5 areas: Aortic, Pulmonic, Erb's Point, Tricuspid, and Mitral; Normal: S1 at apex, S2 at base, no murmurs.

Inspect Extremities

Inspecting arms and legs for size, symmetry, texture, hair, edema, and color; Normal: Equal size, warm, no swelling or varicosities.

Palpate for Temperature and Capillary Refill

Palpating skin for temperature and moisture, checking capillary refill; Normal: Warm, dry, cap refill <2 sec.

Palpate Pulses

Palpating pulses on one side and stating strength; Normal: All pulses 2+ and equal. Radial, Brachial, Popliteal, Posterior Tibial, Dorsalis Pedis.