Checklist For Assessing The Thorax and Lungs

Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
COLLEGE OF HEALTH SCIENCES
Tip #1 – Gather
Information about the
Patient’s History.
Ask the following questions.
1. Have you had any recent
trauma?
2. Have you had any past
surgeries?
3. Do you have any problems with
mobility?
4. Have you noticed a change in
your gait or the way you walk?
5. Have you been diagnosed with
any health condition related to your
musculoskeletal system?
Page 1 GET
6. Do you have a diagnosis of

osteoarthritis or rheumatoid
arthritis?
7. Do you have any bone or joint
deformities?
8. Have you ever had a diagnosis
of any congenital deformities?
9. What medications do you take?
(Some medications can affect the
gait)
Tip #1 – Gather
Information about the
Patient’s History.
Ask the following questions.
1. Have you had any recent
trauma?
Page 2 GET
2. Have you had any past

surgeries?
3. Do you have any problems with
mobility?
4. Have you noticed a change in
your gait or the way you walk?
5. Have you been diagnosed with
any health condition related to your
musculoskeletal system?
6. Do you have a diagnosis of
osteoarthritis or rheumatoid
arthritis?
7. Do you have any bone or joint
deformities?
8. Have you ever had a diagnosis
of any congenital deformities?
Page 3 GET
9. What medications do you take?

(Some medications can affect the
gait)
I. Procedure: ASSESSING
MUSCULOSKELETAL
SYSTEM
II. Purpose:
 To assess the client’s level
of functioning with activities
of daily living
III. Assessment
1. Level of client’s
consciousness
2. Availability and
functionality of the equipment
Page 4 GET
needed
3. Recent weight gain

4. Ability to chew
5. Presence of joint, muscle or
bone pain
6. History of immunization
(polio immunization)
7. Have been diagnosed with
diabetes mellitus
8. For female client:
menopause or not
9. History of rheumatoid
arthritis, gout or osteoarthritis
10.Kind of activities to
promote health: exercise, diet,
weight reducing
Page 5 GET
11. Kind of occupation

12.Smoking tobacco or taking
alcoholic beverages
IV. Planning
A. Preparing the environment,
client and one’s self
1. Make sure the room is at
comfortable temperature
2. Gather the necessary
equipment
3. Perform hand washing
4. Provide rest periods
5. Provide adequate draping
during the examination
Page 6 GET
6. Explained that frequent

change of position is needed
during the
examination
7. Provide clear, simple
directions
8. Demonstrate to the client
how to move the various body
parts
Name of Student: ________________________________ Grade: ________________
Year & Section: ____________________________ Date: _________________
PROCEDURE CHECKLIST
Instruction: Below is the grading scale which will be used in rating your
performance.
5 - well done - 95-100

4 - normally done - 88-94
3 - fairly done - 82-87
2 - poorly done - 76-81
1 - not done - 70-75
I. Procedure: Assessing the Thorax and Lungs

Page 7 GET
II. LEARNING OBJECTIVES: The students will be able to:
 Identify the structural landmarks of the Thorax and Lungs.

 Demonstrate proper assessment of assessing thorax and lungs
III. Equipment Needed
gown and drape skin marker
gloves metric ruler
stethoscope mask
exam light
IV. Method of Assessment
 Tape measure
 Skin marking pen
EQUIPMENT
 Tape measure
EQUIPMENT
 Tape measure
EQUIPMENT
 Tape measure
Page 8 GET

 Observation
 Palpation
 Percussion
 Auscultation
Procedure 5 4 3 2 1 REMARKS
1. Identify yourself and verify the client’s
identity. Explain to the client what you
are going to do, why it is necessary, and
how the client can cooperate.
2. Perform hand hygiene and observe
other appropriate infection control
procedures.
3. Provide for client privacy.
4. Inquires if the client has any of the following:
Page 9 GET
Procedure:
 Have the client sit
 Put your index finger and
middle fingers just anterior to
the external ear opening
 Ask the client to open the
mouth as widely as possible
 the tip of your finger should
drop into the joint spaces as
the mouth opens
 Move the jaw from side to
side
 Protrude (push out and
retract (push in) jaw
Page 10 GET
Family history of illness, including

cancer
 Allergies
 Tuberculosis
 Lifestyle habits such as
smoking, and
occupational hazards
 Any medications being taken
 Current problems such as
swellings, coughs,
wheezing, pain
 Family history of illness, including cancer
 Allergies
 Tuberculosis
 Lifestyle habits such as smoking, and occupational hazards
 Any medications being taken
Current problems such as swellings, coughs, wheezing, pain
Assessment
Posterior Thorax
Page 11 GET
5.
Inspect the
shape and
symmetry of the
thorax
from posterior
and lateral
views. Compare
the
anteroposterior
diameter to the
transverse
diameter.
Inspect the shape and symmetry of the
thorax from posterior and lateral views.
Compare the anteroposterior diameter to
the transverse diameter.
Page 12 GET
6. Inspect the spinal alignment for deformities.

 Have the client stand. From a lateral position, observe the three normal
curvatures: cervical, thoracic, and lumbar
To assess for lateral deviation of

the spine (scoliosis),
observe the standing client bend
forward at the waist,
and observe from behind.
 To assess for lateral deviation of the spine (scoliosis), observe the standing
client bend forward at the waist, and observe from behind.
7. Palpate the posterior thorax.

 For clients who have no respiratory complaints, rapidly assess the temperature
and integrity of all chest skin
For clients who do have respiratory complaints, palpate all chest areas for bulges,
tenderness, or abnormal movements. Avoid deep palpation for painful areas, especially
if a fractured rib is suspected
8. Palpate the posterior chest for respiratory excursion.
Place the palms of both your hands over the lower thorax, with your thumbs adjacent to
the spine and your fingers stretched laterally. Ask the client to take a deep breath while
you observe the movement of your hands and any lag in movement.
9. Palpate the chest for vocal (tactile) fremitus.
 Place the palmar surfaces of your fingertips or the ulnar aspect of your hand or
closed fist on the posterior chest, starting near the apex of the lungs.
 Ask the client to repeat such words as “blue moon” or “one, two, three.”
 Repeat the two steps, moving your hands sequentially to the base of the lungs.
Compare the fremitus on both lungs and between the apex and the base of each lung,
either 1) using one hand and moving it from one side of the client to the corresponding
are on the other side or 2) using two hands that are placed simultaneously on the
corresponding areas of each side of the chest
10. Percuss the thorax.
11. Percuss for diaphragmatic excursion.
Page 13 GET
12. • Auscultate the chest using the flat-disc diaphragm of the stethoscope.Palpate
only one carotid artery at
a time.
• Avoid too much pressure and
Auscultate the chest using the flat-disc diaphragm of the stethoscope.
 Use the systematic zigzag procedure used in percussion
 Ask the client to take slow, deep breaths through the mouth. Listen at each point
to the breath sounds during a complete inspiration and expiration
Compare findings at each point with the corresponding point on the opposite side of the
chest.
Anterior Thorax
13. Inspect breathing pattern.
14. Inspect the costal angle and the angle at
which the ribs enter the spine
15. Palpate the anterior chest.
16. Palpate the anterior chest for respiratory excursion.
 Place the palms of both of your hands on the lower thorax, with your fingers
laterally along the lower rib cage and your thumbs along the costal margins.
Ask the client to take a deep breath while you observe the movement of your hands.
17. Palpate tactile fremitus in the same
manner as for the posterior chest.
 If the breasts are large and
cannot be retracted adequately
for palpation, this part of the
examination usually is omitted.
18. Percuss the anterior chest
systematically.
 Begin above the clavicles in the
supraclavicular space, and
proceed downward to the
diaphragm.
 Compare one side of the lung to
the other.
 Displace female breasts for
proper examination.
19. Auscultate the trachea
20. Auscultate the anterior chest
21. Document findings in the client record.
EQUIPMENT
Page 14 GET
 Tape measure
Page 15 GET

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Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

6. Do you have a diagnosis of

2. Have you had any past

9. What medications do you take?

3. Recent weight gain

11. Kind of occupation

6. Explained that frequent

5 - well done - 95-100

I. Procedure: Assessing the Thorax and Lungs

II. LEARNING OBJECTIVES: The students will be able to:

 Identify the structural landmarks of the Thorax and Lungs.

 Demonstrate proper assessment of assessing thorax and lungs

III. Equipment Needed

gown and drape skin marker

gloves metric ruler

IV. Method of Assessment

 Skin marking pen

Family history of illness, including

6. Inspect the spinal alignment for deformities.

To assess for lateral deviation of

7. Palpate the posterior thorax.

 Skin marking pen

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