general inspection of the Chest - Observation
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