MARCO S.

MORALES BSN 3 A
SKILLS LAB ( NCM 103)

Checklist Assessing Posterior and Anterior Thorax

ASSESSMENT

FINDINGS

1. Inspect the shape and symmetry of the thorax from the posterior to lateral views.

The antereposterior to transverse diameter in ratio of 1:2. The chest contour are both symmetrical. Exaggerated spinal curvatures ( kyphosis) No lumps or masses noted Bilateral symmetry of the vocal fremitus. Fremitus is heard most clearly at the apex of the lungs. Full and symmetric chest expansion when client takes a deep breath. The thumbs separate 3 to 5 cm during deep inspiration. Percussion notes resonate, except over scapula. Lowest point of the resonance is at the diaphragm. Diaphragm is slightly higher o the right side. Soft muffled sound

2. Inspect the spinal alignment for deformities. 3. Palpate the posterior thorax 4. Palplate the vocal fremitus , the faintly perceptible vibration felt through the chest well when the client speaks. 5. Chest expansion

6. Percussion of the thorax

7. Diaphragmatic excursion

8. Auscultation ( Breath sound)

Soft and muffle and three vocal sounds.

9. Vocal sounds

ASSESSMENT

FINDINGS

1. Inspect the breathing patterns. 2. Inspect the costal angle and the angle at which the ribs enter the spine.

Quiet, rhythmic, and effortless respirations Costal angle is less than 90 degrees and the ribs insert into the spine at approximately 45 degrees angle. Full symmetric excursion thumbs normally separate 3 to 5 cm Same as posterior vocal fremitus that is normally decreased over heart and breast tissue. Percussion notes resonate down to the sixth rib at the level of the diaphragm but are flat over areas of heavy muscles and bone Bronchial and tubular breath sounds are normal

3. Palpate the anterior chest for respiratory excursion.

4. Palpate the tactile fremitus

5. Percuss the anterior ches systematically

6. Auscultate the trachea 7. Auscultate the anterior chest

Bronchovesicular and breath sounds are muffled and normal.