Respiratory System Examination
1. Introduction and Preparation
Wash hands.
Introduce yourself to the patient, confirm their identity (name, DOB).
Explain the examination and gain informed consent.
"Hello, my name is [Your Name], and I’m a [Your Year Group] medical student. I’ve
been asked to carry out a respiratory system examination on you today. This will
involve me observing, feeling, tapping, and listening to your chest to assess how well
your lungs are working."
"It shouldn’t be painful at any point, but if you feel any discomfort, please let me
know."
"To do the examination properly, I’ll need you to sit up at an angle on the couch and
remove your top or loosen your clothing so I can examine your chest — but I’ll
ensure your privacy and dignity at all times, and I can provide a gown if you’d like."
"Is that okay with you?" (Wait for consent)
"Do you have any questions before we begin?"
Ensure privacy.
Position the patient sitting upright on the examination couch to a 45 angle.
Expose the chest adequately (offer a gown and keep dignity in mind).
2. General Inspection (End of the Bed)
Observe the patient’s overall appearance:
o Well/ill? Comfortable/distressed?
o Use of accessory muscles, intercostal recession, nasal flaring, pursed-lip
breathing.
o Splinting or tripod posture (e.g., bracing themselves for breath).
o Shortness of breath? Audible wheeze or stridor?
o Presence of cough, sputum pot, oxygen or inhalers.
o Scars, chest wall deformities (visible from end of bed).
3. Hands and Upper Limbs
Inspection of hands:
o Clubbing.
o Tar staining.
o Peripheral cyanosis.
o Muscle wasting (esp. small muscles of the hand – Pancoast tumour).
1. Introduction and Preparation
Wash hands.
Introduce yourself to the patient, confirm their identity (name, DOB).
Explain the examination and gain informed consent.
"Hello, my name is [Your Name], and I’m a [Your Year Group] medical student. I’ve
been asked to carry out a respiratory system examination on you today. This will
involve me observing, feeling, tapping, and listening to your chest to assess how well
your lungs are working."
"It shouldn’t be painful at any point, but if you feel any discomfort, please let me
know."
"To do the examination properly, I’ll need you to sit up at an angle on the couch and
remove your top or loosen your clothing so I can examine your chest — but I’ll
ensure your privacy and dignity at all times, and I can provide a gown if you’d like."
"Is that okay with you?" (Wait for consent)
"Do you have any questions before we begin?"
Ensure privacy.
Position the patient sitting upright on the examination couch to a 45 angle.
Expose the chest adequately (offer a gown and keep dignity in mind).
2. General Inspection (End of the Bed)
Observe the patient’s overall appearance:
o Well/ill? Comfortable/distressed?
o Use of accessory muscles, intercostal recession, nasal flaring, pursed-lip
breathing.
o Splinting or tripod posture (e.g., bracing themselves for breath).
o Shortness of breath? Audible wheeze or stridor?
o Presence of cough, sputum pot, oxygen or inhalers.
o Scars, chest wall deformities (visible from end of bed).
3. Hands and Upper Limbs
Inspection of hands:
o Clubbing.
o Tar staining.
o Peripheral cyanosis.
o Muscle wasting (esp. small muscles of the hand – Pancoast tumour).
