LUNG EXAM
GENERAL
1. ***WASH HANDS***
2. Observe general appearance
3. Inspect
a. Nails
b. Mucous membranes
BREATHING
1. Observe respiration
a. Rate
b. Depth
c. Labored/Unlabored
CHEST
1. Inspect chest wall
a. Deformity
b. AP Diameter
2. Palpate chest wall
a. Anterior Integrity
b. Anterior Symmetry of
expansion
c. Posterior Integrity
d. Posterior Symmetry of
expansion
3. Percuss lung fields bilaterally
a. Anterior (4)
b. Posterior (7)
4. Auscultate lung fields bilaterally
a. Anterior (4)
b. Posterior (7)
SUPPLEMENTAL TESTS
1. Diaphragmatic excursion
a. Ask patient to fully inspire
b. Percuss level of dullness and
mark this as the inferior level
of diaphragmatic excursion
c. Ask patient to fully expire
d. Percuss new level of dullness
and mark this as the superior
level of diaphragmatic
excursion
e. Repeat on both sides,
comparing for symmetry
2. Tactile Fremitus
a. Ask patient to say "ninetynine" in normal voice
b. Palpate 4 locations
bilaterally using ulnar
aspect of hand
3. Broncophony
a. Ask patient to say "ninetynine" in normal voice
b. Auscultate lung fields
bilaterally using
stethoscope
4. Egophony
a. Asking patient to say the
letter "E"
b. Auscultate 7 locations
bilaterally using
stethoscope
5. Whispered Pectoriloquy
a. Ask patient to whisper
"ninety-nine"
b. Auscultate lung fields
bilaterally using stethoscope