pe_lungexam

Ohio State University School of Medicine 
Interactive Learning Center \u2013 Lung Sounds
R.A.L.E Lung Sound Repository
UCLA Heart & Lung Sound Simmulator
Other Auscultation \u201cTools\u201d
\u2022 Egophany \u2013 in setting of suspected 
consolidation, ask patient to say \u201ceee\u201d while 
auscultating. Normally, sounds like \u201ceee\u201d..
Listening over consolidated area generates a 
nasally \u201caaay\u201d sound.
Putting It All Together: Few findings 
pathognomonic Æ put \u2018em together to paint 
best picture.
\u2022 Effusion 
\u2013 AuscultationÆ
decreased/absent 
breath sounds
\u2013 PercussionÆ dull
\u2013 FremitusÆ decreased
\u2013 EgophanyÆabsent
\u2022 Consolidation
\u2013 AuscultationÆ broncial
breath sounds
\u2013 PercussionÆdull
\u2013 FremitusÆincreased
\u2013 EgophanyÆ present
Vs
Summary of Skills 
\u25a1Wash hands
Spine
\u25a1 Inspect (shape, curves); Examine (range of motion, palpation)
Lungs and Thorax
Observation & Inspection 
\u25a1 Patient breathing
\u25a1 Chest shape
\u25a1 Fingers/nails
Palpation
\u25a1 Chest excursion 
\u25a1 Fremitus 
Percussion
\u25a1 Alternating R & L lung fields posteriorly topÆbottom; & anteriorly
\u25a1 Determines diaphragmatic excursion
Auscultation
\u25a1 R & L lung fields posteriorly, top Æbottom, comparing side to side
\u25a1 R middle lobe
\u25a1 Anterior fields bilaterally
Time Target: < 10 minutes
	Lung, Thorax & Spine Exams
	Exposure Is Key \u2013 You Cant Examine What You Can\u2019t See!
	Anatomy Of The Spine
	Spine Exam
	Pathologic Changes In Shape Of Spine
	Lung Exam
	Observation\ufffd
	Observation (cont)
	Pathologic Changes In Shape Of Chest
	Clubbing and Cyanosis
	Slide Number 11
	Thoughts On Gown Management & Appropriately/Respectfully Touching Your Patients
	Keys To Performing a Respectful & Effective Exam
	Slide Number 14
	Good Exam Options
	Palpation
	Palpation \u2013 Assessing Fremitus 
	Lung Pathology - Simplified
	Fremitus - Pathophysiology
	Percussion
	Percussion - Technique
	Percussion (cont)
	Expect To Be Frustrated!
	Percussion: Normal, Dull/Decreased or Hyper/Increased Resonance
	Ausculatation
	Lobes Of Lung
	Lobes Of The Lung (cont)
	Trachea
	Auscultation (listening w/Stethescope) - Technique
	Pathologic Lung Sounds
	Pathologic Lung Sounds (cont)
	Lung Sounds
	Other Auscultation \u201cTools\u201d
	Putting It All Together: Few findings pathognomonic \uf0e0 put \u2018em together to paint best picture.
	Summary of Skills