Hi there my name is Andrew, one of the final year medical students. Could I just check your name and date of birth, please? Sure it's James Alexander 30th of December 1989.
- Nice to meet you, James. Today I've been asked to examine your chest. This will involve looking from the end of the bed.
Feeling different parts of the chest and then listening with the stethoscope at the end. Would that be okay? - That sounds fine.
Billiant. Have you any pain anywhere at alL? - No.
Have you any questions about the exam? - No, I don't. Okay.
Okay, James. We can start the exam now, and I'm just going to start by having a look from the end of the bed. James I'd like to start by looking at your hands.
If you could just bring them up in front of you, please. And if you could turn them over. Fantastic, and if you could bring two fingernails together, like this, for me.
And again if you could just bring your arms out in front of you. I'm just going to assess the temperature of your arms. Now if you could bring your arms out in front of you like this, and keep them there.
And cock your wrists back, James, and keep them there. And relax. I would now like to feel the pulse in your wrist.
Could you just turn your head to the left for me? And bring your head back. James, I'm now gonna have a look at your face and eyes, okay?
If you could just look straight ahead for me. And I'm now gonna pull down on your lower eyelid. If you could just open your mouth for me.
And lift your tongue to the roof of the mouth. That's great. I'd now like to more closely inspect the chest.
If you could just lift your right arm up for me? And your left arm? I'm now just going to feel the position of your windpipe.
Let me know if it's too uncomfortable. I'm now going to assess the expansion of the chest. This will just involve me placing my hands around the chest, quite tightly, then asking you to take a deep breath in.
Deep breath. And out. And in.
And out. I would now like to tap on the chest. James, I am now gonna listen to the chest if you could just take some deep breaths in and out through your mouth.
This time, James, every time I place my stethoscope on the chest could you say ninety nine for me? Ninety nine. Ninety nine.
Ninety nine. Ninety nine. Ninety nine.
Ninety nine. Ninety nine. Ninety nine.
Ninety nine. Ninety nine. James, if you could now sit forward for me.
I'd like to examine for any glands in the neck. I'm just going to more closely look at you back now. Like before, James, I'd like to examine for chest expansion now.
So this will just involve me putting my hands tightly around the chest again and asking you to take a deep breath in. Deep breath. And out.
And in. And out. James, I'm now gonna tap on your back.
If you could just fold your arms for me. James, I am now gonna listen to your back. If you could just keep your arms folded.
And breathe in and out through your mouth for me. And now if you could say ninety nine for me. Ninety nine.
Ninety nine. Ninety nine. Ninety nine.
Ninety nine. Ninety nine. Ninety nine.
Ninety nine. Ninety nine. Ninety nine.
And I'm now just gonna press on your lower back. Let me know if you have any pain in your calves. James, that completes the examination.
Thank you very much, you can now get dressed. In summary, I performed a respiratory exam on James, a 27 year old male. James had no peripheral stigmata or respiratory disease, his pulse was regular, and he had a normal respiratory rate.
James had a normal and symmetrical percussion note on the front and back of the chest. On auscultation James had normal vesicular breathing with no added sounds. This was a normal respiratory exam.
To complete the respiratory exam, I'd like to measure James's oxygen saturations, And also send off a sputum sample.
