F00574 019 g001
Face, mouth and eyes
Pursed lips? Central cyanosis?
Anaemia? Homer's syndrome (Ch. 26)
Hands
Digital dubbing Tar staining Peripheral cyanosis Signs of occupation CO2 retention flap
|
A |
•r (A | |
|
1 IHl | ||
|
ii |
m | |
|
mm |
r S 4 \ | |
|
f JS |
Finger dubbing A
Thorax (
(see opposite)
Jugular venous pulse
Elevated?
Pulsatile?
Blood pressur
Arterial paradox?
Radial pulse
Ratę
Rhythm
Percussion
Resonant7 Duli? 'Stony duli' (effusion)
Leg oedema
? Cor pulmonale ? Venous thrombosis
Locale
Oxygen delivery (mask, cannulae)
Nebulisers
Inhalers
Observation
Respiratory ratę Cachexia. fever, rash? Sputum (see below) Fetor
A Idiopathic kyphoscoliosis
Palpation
From the front:
Trachea central Cricosternal distance Cardiac apex displaced7 Expansion From behind:
Cervical lymphadenopathy Expansion
Auscultation
Breath sounds:
normal, bronchial, louder or softer? Added sounds: wheezes, crackles, rubs Spoken voice (vocal resonance): absent (effusion), increased (consolidation)?
Whispered voice: whispering pectoriloguy
Sputum
A Serous/frothy/pink Pulmonary oedema
A Mucopurulent Bronchial or pneumonic infection
A Purulent
Bronchial or pneumonic infection
A Blood-stained Cancer, tuberculosis, bronchiedasis, pulmonary embolism
© Elsevier. Boon et al.: Davidson's Principles and Practice of Medicine 20e - www.studentconsult.com
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