Respiratory exam

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Author:
jaz_walker
ID:
188495
Filename:
Respiratory exam
Updated:
2012-12-10 14:35:01
Tags:
OSCE medicine
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Description:
medicine osce
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  1. 0. Preparing patient.(5)
    • Gain verbal consent,
    • perform hand hygeine.
    • Ask for exposure from waist up.
    • Bed at 45 degrees.
    • Approach from right.
  2. 1. General inspection from head of bed. (12)
    • pallor, cough, SOB,
    • sweating, distress, cyanosis,
    • body habitus,
    • accessory muscle straining,
    • barrel chest, pigeon chest
    • stridor, hoarseness
  3. 2. Looking around the bed (5)
    • medications
    • eating/drinking,
    • mobility aids
    • sputum pot
    • oxygen aides
  4. 3. Examine nails and hands. (8)
    • clubbing, peripheral cyanosis,
    • tobacco staining, yellow nails
    • asteriksis,
    • fine salbutamol/theophylline tremor
    • steroid treatment thin skin
    • raised nontender firm subcutaneous nodules
  5. 6. Examine neck (6)
    • Raised JVP, 'cannon a waves'
    • Kussmaul's sign, carotid pulse
    • trachela deviation, tracheal drag
  6. 7. Examine face (1)
    Examine eyes for ptosis/partial ptosis (Horner's syndrome)
  7. 8. Examine chest (3)
    • scars,
    • chest drain
    • deformity e.g. kyphoscoliosis, pigeon chest
  8. 9. Examine back (10)
    • Check expansion of chest, Ask for cough
    • Percuss back, and apices.
    • Auscultate back.
    • whispering petriloquoy
    • pitting oedema
    • lymphadenopathy
    • Percuss front and axilla
    • Auscultate front and briefly listen to heart
  9. 9. Check legs (2)
    • oedema
    • erythema nodosum
  10. 10. To finish examination (4)
    • Peak flow rate 
    • Oximetry
    • General obs (RR, HR, BP, temp)
    • bloods for respiratory acidosis

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