thorax and lungs

    Cards (16)

      1. Gather equipment (gown and drape, gloves, stethoscope, exam light, mask, skin marker, metric ruler)
      2. Explain the procedure to client.
      3. Ask the client to put on a gown.
    • Posterior thorax
      1. Inspect for shape and configuration of the chest wall and position of scapulae.
      2. Inspect for use of accessory muscles.
      3. Inspect the client's positioning noting posture and ability to support weight while breathing.
      4. Palpate for tenderness and sensation with gloved fingers.
      5. Palpate for surface characteristics such as lesions or masses with gloved fingers.
    • Posterior Thorax
      6. Palpate for fremitus, using the ball or ulnar edge of one hand while the client says "ninety nine". Assess for symmetry and intensity of vibration.
      7. Palpate for chest expansion. Place hands on the posterior chest wall with your thumbs at the level of T9 or T10, and observe the movement of your thumbs as the client takes a deep breath.
      8. Percuss for tone, starting at the apices above the scapulae and across the tops of both shoulders.
    • 13. Auscultate for adventitious sounds (crackles, fine or coarse, pleural friction rub, wheeze, sibilant, or sonorous).
      14. Auscultate for voice sounds over the chest wall:
      Bronchophony-- ask the client to repeat the phrase "ninety-nine", egophony-- ask the client to repeat the letter "E", whispered pectoriloquy--ask the client to whisper the phrase "one-two-three.
    • 9. Percuss intercostal spaces across and down, comparing sides.
    • 10. Percuss to the lateral aspects at the bases of the lungs, and compare sides.
    • 11. Percuss for diaphragmatic excursion.
    • 12. Auscultate for breath sounds (normal: bronchial, bronchovesicular, and vesicular), noting location.
    • Anterior Thorax
      1. Inspect for shape and configuration to determine the ratio of anteroposterior diameter to transverse diameter (normally 1:2).
      2. Inspect for position of sternum from anterior and lateral viewpoints.
      3. Inspect for slope of the ribs from anterior and lateral viewpoints.
      4. Inspect for quality and pattern of respiration, noting breathing characteristics, rate, rhythm, and depth.
    • Anterior Thorax
      5. Inspect intercoastal spaces while client breathes normally.
    • Anterior Thorax
      6. Inspect for use of accessory muscles.
      7. Palpate for tenderness and sensation, using fingers.
    • Anterior Thorax
      8. Palpate surface characteristics such as lesions or masses, using fingers of gloved hand.
    • Anterior Thorax
      9. Palpate for fremitus while the client says "ninety-nine".
    • Anterior thorax
      10. Palpate for chest expansion by placing hands on anterolateral wall with the thumbs along the costal margins and pointing toward the xiphoid process. Observe the movement of the thumbs as the client takes a deep breath.
    • anterior thorax
      11. Percuss for tone above the clavicles and then the intercostal spaces across and down, comparing sides.
    • anterior thorax
      12. Auscultate fro breath sounds, adventitious sounds, and voice sounds.
    See similar decks