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Chest Examination

Inspection:

• Breathing Pattern: Observe for signs of labored breathing, use of accessory muscles, or nasal flaring during breathing.

Chest Examination

Inspection:

• Breathing Pattern: Observe for signs of labored breathing, use of accessory muscles, or nasal flaring during breathing. In some cases, patients with asthma may adopt a "tripod position" (sitting forward with hands on knees) during an acute attack.


• Posture: Look for any abnormal postures, such as a hunched back, which may indicate muscle fatigue or discomfort while breathing.


• Cyanosis: Check for a bluish discoloration of the lips or extremities, which may indicate hypoxemia (low oxygen levels).

Palpation:

• Chest Expansion: Assess for symmetrical chest expansion. Reduced expansion on forced expiration may be present due to airflow obstruction.


• Tactile Fremitus: A decrease in tactile fremitus might be observed, indicating air trapping in the lungs.


• Tenderness: Palpate the chest wall for tenderness, which may result from frequent coughing or muscle strain during breathing.

Percussion:

• Hyper-resonance: Percussion may reveal hyper-resonance, suggesting air trapping in the lungs, a common finding in asthma.


• Dullness: If the patient has co-existing infection, dullness may be noted in the areas where consolidation or fluid accumulation is present.

Auscultation:

• Wheezing: The presence of high-pitched wheezing, particularly on expiration, is a hallmark sign of asthma due to bronchospasm.


• Breath Sounds: Breath sounds may be reduced in areas of severe obstruction, or in the presence of mucus.


• Prolonged Expiration: In asthma, the expiratory phase is often prolonged due to narrowed airways.


• Crackles: If there is an underlying respiratory infection or inflammation, crackles might be heard at the lung bases