1. Respiratory examination

2. Components 1- General Ex 2- Inspection: from front and back 3-Palpation 4-Percussion 5-Auscultation

3. General respiratory Ex We will cover these points : 1- general look 2- vital signs 3- both hands 4- eyes 5- nose 6- mouth 7- sinuses 8- neck 9- Lower limb edema

4. General look Consciousness Oriented Distressed Lying flat Audible wheezing or stridor Connected to IV line or O2 mask Lip pursing Acting nasal alae Using accessory muscle A : apperance B : body built C : color D : distressed E : environment

6. Hands 1- Nail Clubbing, cyanosis, nicotine staining 2-palm Warm, pallor 3-Dorsum Muscle wasting 4-Tremor Fine, flapping

8. 5- Eyes Pallor, jaundice, sign of Horner syndrome 6- Nose Acting nasal alae 7- Mouth Central cyanosis in the tip of the tongue Peripheral cyanosis in lip or fingers Lip pursing

9. 8- Sinuses 9- Neck JVP Using accessory muscle LN

10. Chest By inspection Type of breathing, symmetry, scar, deformity like. Pectus excavatum, pectus carinatum, barrel chest, Harrison sulcus Prominent veins, intercostals retraction back, kyphosclosis

11. Pectus excavatum

12. pectus carinatum

14. By palpation Tactile vocal fremitus Chest expansion Tracheal tug Tracheal deviation Apex beat

15. By percussion ( Resonant – Dull -Hyperresonant) ? Symmetrical?

16. By auscultation 1- Air entry ( Breathing sounds) 2- Type of breathing 3- Added sounds like wheezing and fine or coarse crepitations or pleural friction rub 4- Vocal resonance

19. Thank you