Palpation of the chest

Patient has painful point along the right axillary line from 4^th till 7^th intercostals spaces, the positive Potenzher’s sign of the right side.

Elasticity of the chest is not changed.

The vocal fremitus is amplified at the right subscapular and axillary areas.

Percussion of the lungs

1. Comparative percussion of the lungs: Over the right part of the chest at the subscapular and axillary areas the dull percussion sound is revealed. Over the other areas of the lung is revealed clear lung sound.

2. Topographic percussion of the lungs:

The upper borders of the lungs: apex height - left lung 4 cm, right lung – 4 cm.

Krenig’s areas width: left lung – 5 cm, right lung – 5,5 cm.

Determination of the lower borders of the lungs (along topographic lines: right from parasternal till paraspinal, left from axillary anterior till paraspinal).

Position of the lower lung borders

Topographic lines	Right lung	Left lung
Parasternal line	V interspace	-
Midclavicular line	V rib	-
Anterior axillary line	IV rib	VII rib
Midaxillary line	V rib	VIII rib
Posterior axillary line	V rib	IX rib
Scapular line	VII rib	X rib
Paravertebral line	Spinous process of VII chest vertebra	Spinous process of XI chest vertebra

The excursion of the lower borders of the lungs:

Right midaxillary line – 2 cm.

Left midaxillary line – 10 cm.

Auscultation of the lungs:

Over the left lung, frontal and upper part of the right lung the rough vesicular breathing is hearing. Under the scapular and in the right axillary region the bronchial breathing and the pleural friction pub is heard.

Assessment of the respiratory system examination

During examination of the respiratory system we have revealed a lot of pathological signs: lagging right part of the chest from the left one, tachypnea (36 per min), participating accessory muscles (neck, back and nose muscles) in breathing, amplifying vocal fremitus over the right lung, painful point along the right axillary line from 4^th till 7^th intercostals spaces, the positive Potenzher’s sign of the right side. By percussion we have found dull sound over the right lung, upward shift of the right lower border of the lung, limiting excursion of the right lungs edge. By auscultation the pathological bronchial breathing and the pleural friction pub is heard over the right lung. All enumerated signs were founded in the right lung and may indicate syndrome of the consolidation of the lower lobe of the right lung. Tachypnea may be a sign of the respiratory failure.

Дата добавления: 2015-11-14