THORAX AND LUNGS

• Thorax and lungs


  Part of the body being assessed
• Subjective assessment


  1. History of present health concerns

  2. Difficulty of breathing

  3. Chest pain

  4. Cough
• Difficulty of breathing


  • Onset
  • Duration
  • Pattern
  • Associated factors
• Chest pain


  • Is the pain associated with a cold, fever or deep breathing
• Cough


  • When and how often does it occur
  • Do you produce any sputum when you cough
• Personal health history


  • Prior respiratory problems
  • Thoracic surgery, biopsy or trauma
  • Allergies
  • Medications
  • Chest x-ray, tuberculosis skin test or influenza immunization
  • Recent travel outside of country
• Family health history


  • Lung disease
  • Family members smoking when growing up
  • Other pulmonary illnesses/disorders
• Lifestyle and health practices

  • Diet
  • Smoking
  • Exposure to environmental hazards
  • Stress
  • Medications
  • Treatments for respiratory problems
  • Herbal medicines
• Objective assessment


  1. Preparing the client

  2. Inspection

  3. Palpation

  4. Percussion

  5. Auscultation
• Inspection of posterior thorax


  • Configuration
  • Use of accessory muscles
  • Client's positioning
• Palpation of posterior thorax

  • Tenderness and sensations
  • Crepitus
  • Surface characteristics
  • Fremitus
  • Chest expansion
• Percussion of posterior thorax

  • Tone
  • Diaphragmatic excursion
• Auscultation of posterior thorax

  • Breath sounds
  • Adventitious breath sounds
  • Voice sounds
• Inspection of anterior thorax

  • Shape and configuration
  • Position of the sternum
  • Sternal retraction
  • Slope of the ribs
  • Quality and pattern of respiration
  • Intercostal space
  • Use of accessory muscles
• Palpation of anterior thorax

  • Tenderness, sensation and surface mass
  • Tenderness at costochondral junction
  • Crepitus
  • Surface masses or lesions
  • Fremitus
  • Chest expansion
• Percussion of anterior thorax

  • Tone (air filled, fluid filled, dense)
• Auscultation of anterior thorax

  • Anterior breath sounds, adventitious breath sounds and voice sounds