Inspection
Inspection or observation involves observing the respiratory rate which should be in a ratio of 1:2 inspiration:expiration. It is best to count the respiratory rate under pretext of some other exam, so that patient does not sub consciously increase his baseline respiratory rate. An acidotic patient will have more rapid breathing to compensate known as Kussmaul breathing. Another type of breathing is Cheyne–Stokes respiration, which is alternating breathing in high frequency and low frequency from brain stem injury. It can be seen in newborn babies which is sometimes physiological (normal). Also observe for retractions seen in asthmatics. Retractions can be supra-sternal, where the accessory muscles of respirations of the neck are contracting to aid inspiration. Retractions can also be intercostal, in which there is visible contraction of the intercostal muscles (between the ribs) to aid in respiration. This is a sign of respiratory distress. Observe for barrel-chest (increased anterior-posterior diameter) seen in chronic obstructive pulmonary disease (COPD). Observe for shifted trachea or one sided chest expansion, which can hint pneumothorax.
- Tracheal deviation (can suggest of tension pneumothorax)
Read more about this topic: Respiratory Examination
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