MSN 551
Thorax and Lungs Skills Checklist
Skills
Prepare environment, gather equipment, maintain medical
asepsis
Inspect:
• Assess rate, rhythm, depth of breathing
• Skin color (note cyanosis)
• Shape of the chest ( note AP diameter)
• Symmetry of the chest movements
• Accessory muscle use
Palpate (anterior and posterior):
• Chest expansion (note asymmetry)
• Tactile fremitus (note areas of increased/
decreased fremitus)
• Tenderness
Percuss anterior and posterior chest (note areas of
resonance, hypo-resonance, hyper-resonance)
Percuss posterior chest to identify the extent of
diaphragmatic excursion
Auscultate (anterior and posterior):
• Breath sounds (vesicular, bronchial, tracheal)
• Note adventitious sounds:
✓ Discontinuous (crackles or rales)
✓ Continuous (wheezing and rhonchi)
Special tests (auscultation for transmitted voice sounds) if
abnormalities on the standard exam:
✓ Egophony
✓ Bronchophony
✓ Whispered pectoriloquy
Thorax and Lungs Skills Checklist
Skills
Prepare environment, gather equipment, maintain medical
asepsis
Inspect:
• Assess rate, rhythm, depth of breathing
• Skin color (note cyanosis)
• Shape of the chest ( note AP diameter)
• Symmetry of the chest movements
• Accessory muscle use
Palpate (anterior and posterior):
• Chest expansion (note asymmetry)
• Tactile fremitus (note areas of increased/
decreased fremitus)
• Tenderness
Percuss anterior and posterior chest (note areas of
resonance, hypo-resonance, hyper-resonance)
Percuss posterior chest to identify the extent of
diaphragmatic excursion
Auscultate (anterior and posterior):
• Breath sounds (vesicular, bronchial, tracheal)
• Note adventitious sounds:
✓ Discontinuous (crackles or rales)
✓ Continuous (wheezing and rhonchi)
Special tests (auscultation for transmitted voice sounds) if
abnormalities on the standard exam:
✓ Egophony
✓ Bronchophony
✓ Whispered pectoriloquy
