Pulmonary History Taking & Examination In Surgical Patients

History Taking & Examination in Surgical Patients

Anatomic Considerations • Thorax divided into: – – – –

Chest wall Pleural space Pulmonary parenchyma (Lungs) Mediastinal Structures

• Intrapleural pressure

Clinical Assessment • History: – Trauma – Occupation – Smoking

• General examination: – – – –

Cyanosis Clubbing Dyspnea Stridor

Clinical Assessment (cont’d) • Chest examination: – Position – Inspection – Palpation: • Rib counting • Centralization of the trachea

– Percussion – Auscultation

Physical Signs • Thoracic injuries: – Fractured rib – Flail chest – Sternal fracture

Physical Signs (cont’d) • Lung injuries: – – – –

Haemothorax Pneumothorax Lung contusion Lung laceration