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Clinical Examination


The "art" of medicine has a basic principle: we only treat properly when we have a diagnosis.
In order to make a proper diagnosis we carry out  clinical examination of the patient. The doctor uses the medical history and the clinical examination to identify the root of the problem.
We view respiratory patients as a whole rather than as a chest.

The basic stages of the clinical examination to which the patient undergoes are the following.

Observation : By observing the face, chest, limps and the way the patient speaks and walks, the doctor can identify signs to diagnose the condition. For example, the respiratory patient often has tachypnoea (rapid breathing), wheezing and sometimes leg edema but also cyanosis when respiratory failure is present. Clubbing of the digits, distendent chest veins, use of intercostal muscles, distendent jugular veins and chest malformations are very important findings in the assessment of a respiratory patient.
Percussion: with percussion the doctor is possible to diagnose fluid in the lung (dullness), pneumothorax (hyperresonance) and heavy emphysema (widespread hyperresonance)

Palpation : includes examination of the chest wall for any additional sounds (palpable vibrations) and palpation of lymphatic groups to locate swollen lymph nodes.
Auscultation: pulmonology and auscultation are always carried out together. A rage of abnormal lung sounds arises from respiratory diseases: musical adventitious sounds (obstructive lung diseases), coarse  cracles (heart failure, secretions),  fine cracles  (pulmonary fibrosis, pneumonia) and decrease the intensity of lung sounds (fluid in the lung). All of the above provide the physician with information to make a correct diagnosis.