general inspection of the Chest - Observation

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Observe the following:
  • evidence of respiratory distress:
    • dyspnoea
    • tachypnoea
    • use of accessory muscles of respiration
    • wheezing or stridor
  • signs of respiratory failure:
    • reduced level of consciousness
    • central cyanosis
    • asterixis
  • chest wall:
    • hyperexpanded in airways obstruction
    • kyphosis or scoliosis
    • pectus carinatum or pectus excavatum
    • asymetric expansion
    • surgical scars, possible tracking mesothelioma
    • cold abscesses from underlying TB
    • Harrison's sulcus and intercostal recession
  • pattern of respiration
  • lymphadenopathy, especially supraclavicular
  • superior vena cava obstruction:
    • puffy face
    • engorged neck, chest and arm veins
  • hoarse voice
  • Horner's syndrome
  • signs in the hands:
    • nicotine on fingers and nails
    • coal dust ingrained in fingers and nails
    • clubbing
    • wasting of small muscles
    • yellow nails in the yellow nail syndrome

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