Examination of the respiratory system should be preceded by careful public opinion. Shortness of breath, cyanosis, digital club scene and cervical or axillary lymphadenopathy may primarily respiratory problems.

For the purposes of examination, the chest is divided into different areas in order to make the younger locate wounded. Forex part is divided into supraclavicular, infraclavicular, mammary and inframammary regions. The laterally divided into axillary and infra-axillary areas again is divided into suprascapular, interscapular and infrascapular areas. Medical examination is carried out in a series of inspection, palpation, percussion and tape measurement of the circumference. Measurement of chest expansion is simple and reliable clinical method to evaluate the ventilatory capacity, normal expansion in adults extends from 6-8c

Percussion :.
The note raised by percussion and vibration felt by plexi meter finger gives valuable clues to the state of the underlying lung and pleura. By percussion it is possible to evaluate the relative proportion of air, solid tissue or fluid underlying the area

clinically relevant changes in percussion note
Normal lung -. Resonant normally
Hollow Entries penumothorax – Tympanitic
Moderate pneumothorax, emphysema, vesicles so – Hyper-resonant
Consolidation, collapse, fibro-thorax – Impaired resonance to moderate dullness
pleural effusion, emphysema, thick fibrothorax – stony dullness.

Special forms percussion include “tidal percussion” and “elicitation shifting dullness”. The first is used to distinguish dullness caused by the upper edge of the liver that caused by pleural fluid or consolidation of the lower part of the lungs. Shifting dullness occurs when there is a liquid that is free to move by changing the position of the patient. This happens hydropneumothorax or in a large pit containing liquid and air

Auscultatory results :.
Breath sounds, vocal resonance and whispering pectoriloquy are induced by tape measurement of the circumference. Breath sounds are produced by a swing set in the larger air travel (trachea and larger bronchi) by turbulent air. The larger air way nature breath sounds is bronchial. In the lower areas of pulmonary parenchyma acts as a low pass filter which filters out the higher frequency components (200 Hz and above) and this changes the nature of the spirit sounds blister. When this filtering effect is lost, the sounds are directly transmitted to the chest wall and breath sounds become bronchial. This happens jointly lungs. This is Acoustic basis bronchophony and whisper pectoriloquy as well. External sound heard on the tape measurement of the circumference may be “wheezes” (formerly called “Snort”) and “debris” (used to be known as “crepitations”)

Andi sounds :.
Normal breath sounds are blisters. This phase is characterized by inspiration, followed by a short expiratory phase (third of inspiration) and quality being rustling. In bronchial breathing exhalation volumes and inspiratory phases are equal with breaks in between and the quality is guttural or aspirate. Normally bronchial breathing is heard over the trachea, when auscultated over the front and back of the neck. Pathological organizations bronchial breathing include pulmonary consolidation, collapse adjacent patent bronchi or rarely other conditions. Based on the pitch, bronchial breathing has been described as “tubular” (high pitched), “cave nous” (low pitch) and “amphoric” (low pitched breath sounds with high pitched overtones). “Tubular breathing” is heard over the lung disease group, “cave nous breathing” over communicating cavities and large air passages and “amphoric breathing” over open pneumothorax and large communicating cavities. “Bronchophony” (increased vocal resonance) occurs over areas of consolidation, “whispering pectoriloquy (whispered sounds heard clearly auscultating feed) can be achieved over areas of bronchial breathing. When only high frequency sounds of spoken voice is transmitted to the chest wall, vocal resonance achieved nose – quality and this is termed “aegophony”. This can achieve the level of pleural effusion.

external sound can be continuous or interrupted. “Continuous external sound” are:.

• vacuum come the larynx and bronchial obstruction and
• “wheezes” arising from the venturi air passages interrupted external sounds are crackles (which can be fine, medium or coarse) and pleural outflow rubs rupture (crepitations) are produced by explosive balance gas pressure between boluses in air travel and sequestial open the airways of the respiratory cycles. Mature crepitations may be due to the presence of fluids in larger air as they disappear with cough and expectoration.

Medical pulmonary clinical cases is quite an interesting one, however, not as simple as they sound. They need a of the technical side.