A deep dive on the "core" pulmonary exam - the exam of the lungs that one would perform on a new primary care patient, or on a patient being admitted to the hospital for an issue not directly related to the lungs. I discuss abnormal respiratory patterns, signs of respiratory distress, barrel chest, clubbing, and of course, lung auscultation (e.g. crackles, wheezes, rhonchi, etc...)

@0:00 Introduction
@1:40 Inspection of the respiratory pattern
@5:31 Remainder of inspection (e.g. resp. distress, barrel chest, clubbing)
@12:27 Review of lung anatomy for auscultation
@13:57 Demonstration of lung auscultation
@17:30 Lung Auscultation - breath sounds
@19:25 Lung Auscultation - adventitious sounds (e.g. crackles, wheezing)
@27:34 Concluding clinical pearls & documentation of the lung exam


References:

McGee S. Evidence Based Physical Diagnosis. 5th Ed. Elsevier; 2021.

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McFadden JP, Price RC, Eastwood HD, Briggs RS. Raised respiratory rate in elderly patients: a valuable physical sign. Br Med J. 1982;284:626–627.

McGee SR. Cheyne-Stokes breathing and reduced ejection fraction. Am J Med. 2013;126:536–540.

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Pierce JA, Ebert RV. The barrel deformity of the chest, the senile lung and obstructive pulmonary emphysema. Am J Med. 1958;25:13–22.

Golub RM. Validity and Reliability of the Schamroth Sign for the Diagnosis of Clubbing. JAMA. 2010;304:159-161.

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Piinla P, Sovijarvi ARA. Crackles: recording, analysis and clinical significance. Eur Respir J. 1995;8:2139-2148.

Wang CS, et al. Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure? JAMA. 2005; 294:1944-1956.

#physicalexam #respiratory #OSCE

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