1
,-Trachea
-Bronchi
-Bronchioles
-Alveolar Sacs
-Alveoli
Landmarks-Visualize what you cannot see!
-Anterior chest
-Suprasternal notch ―U shaped‖
-Sternum
-Sternal angle (Angle of Louis) continuous with 2nd rib
-Ribs & intercostals
-Costal angle (at xiphoid) 90 degrees
-Posterior chest
-Vertebra prominence C7
-Spinous processes T1 is 1st rib
-T3 separates upper and lower lobes
-Inferior border of the scapula 8th rib
-12th rib
Subjective Data
, -Difficulty breathing, sleeping, chest pain, cough and sputum (Rusty-TB), smoking history,
environmental exposure
TO calculate smoking pack-years
1. Multiple the number of cigarettes smoked per day by number of years smoked
2. Divide by 20
i.e 10 cigarettes smoked per day x 10 years / 20 = 5 pack years
Objective Data
-Inspection of patient: Resp. rate & effort to breathe (Nasal flaring, accessory muscles,
positioning) skin color, nails, configuration of chest (Chest deformities)
-Palpation of anterior and posterior chest: Tenderness, lumps, crepitus (Subcutaneous air-rice
krispis under skin), tactile fremitus (99), respiratory expansion
-Percussion of lung fields: Resonance, hyper-resonance, dull, diaphragmatic excursion
-Auscultation of chest: Normal, adventitious, voice sounds, measurements of pulmonary
function: For screening**Begin at the moment of contact
Normal breath sounds
-Bronchial (Tracheal) –Over trachea & larynx E>1
-Bronchovesicular—Over major bronchi I=E
-Vesicular—over peripheral lung fields I>E
Normal Assessment Findings
,-Trachea
-Bronchi
-Bronchioles
-Alveolar Sacs
-Alveoli
Landmarks-Visualize what you cannot see!
-Anterior chest
-Suprasternal notch ―U shaped‖
-Sternum
-Sternal angle (Angle of Louis) continuous with 2nd rib
-Ribs & intercostals
-Costal angle (at xiphoid) 90 degrees
-Posterior chest
-Vertebra prominence C7
-Spinous processes T1 is 1st rib
-T3 separates upper and lower lobes
-Inferior border of the scapula 8th rib
-12th rib
Subjective Data
, -Difficulty breathing, sleeping, chest pain, cough and sputum (Rusty-TB), smoking history,
environmental exposure
TO calculate smoking pack-years
1. Multiple the number of cigarettes smoked per day by number of years smoked
2. Divide by 20
i.e 10 cigarettes smoked per day x 10 years / 20 = 5 pack years
Objective Data
-Inspection of patient: Resp. rate & effort to breathe (Nasal flaring, accessory muscles,
positioning) skin color, nails, configuration of chest (Chest deformities)
-Palpation of anterior and posterior chest: Tenderness, lumps, crepitus (Subcutaneous air-rice
krispis under skin), tactile fremitus (99), respiratory expansion
-Percussion of lung fields: Resonance, hyper-resonance, dull, diaphragmatic excursion
-Auscultation of chest: Normal, adventitious, voice sounds, measurements of pulmonary
function: For screening**Begin at the moment of contact
Normal breath sounds
-Bronchial (Tracheal) –Over trachea & larynx E>1
-Bronchovesicular—Over major bronchi I=E
-Vesicular—over peripheral lung fields I>E
Normal Assessment Findings
