Introduction  Palpate the chest for vocal (tactile)

fremitus ( sabihin ng patient 99 or

 Name, age
ung tres-tres) use ulnar part of hand.
 History, family history (about cancer Assess all areas for symmetry and
sa lung, heart tsaka breast) intensity of vibration
Assessing the thorax  Percuss the thorax, percuss per tone
starting at the apices of the scapulae
 inspect the shape and symmetry of and across the top of both shoulder
thorax from posterior and lateral resonance is the percussion tone
views (abnormal findings: kyphosis, elicited over normal lung tissue.
lordosis & scoliosis) Percussion elicits flat tones over the
 inspect the spinal alignment for scapula. (<<<< ung pic dito sa
deformities (abnormal findings: palpate don den ung pepercuss)
Barrel ches, Pigeon chest and Funnel  Percuss for diaphragmatic
chest) excursion, hanapin muna T7 tas sa
 palpate the posterior thorax, palpate
for tenderness, warmth, pain and
other sensation.

left side below ng scapula place your

fingers and tell your patient to
inhale. Then percuss pababa
 Palpate the posterior chest for hanggang sa maging dull ung tone.
respiratory excursion (sa T9 or T10 Tas pag dull na mark mo yun and tell
tas inhale exhale) there must be full the patient to exhale, inhale ulit tas
and systemic expansion and the pababa ulit start don sa namark
thumbs must be separated to 3cm mong dull kanina tas percuss pababa
during deep inspiration when ulit until maging dull ung tone then
assessing for respiratory excursion mark it <pag pinepercuss mo kasi
diba resonance- resonance-
resonance then magiging dull> . bali
dalawa na ung mark tas susukatin
mo siya gamit ruler, normal should
be 3-5cm
  Auscultate the chest using the flat  evaluation of breast mass
disc diaphragm of the stet. Place the o breast lump
stet on posterior chest wall at the o demarcation
apex of the lung at c7, then ask the o mobility
patient to breathe deeply through o tenderness
her mouth for each area of o retraction
auscultation para marinig ung
respiratory and exploratory sounds. Assessing the heart
There must be three types of normal
breath sounds bronchial, broncho
vesicular and vesicular. ( same
location ulit katulad nung pic sa
unang palpate)

If papagawa sainyo sa anterior part same lang

den ng ginawa mo sa posterior ung gagawin
pero baka di na hahaha
 inspect and palpate the precordium
Assessing the breast and axillae or the presence of abnormal
 Inspect the breast size, symmetry, pulsations, lifts, or heaves. Lay your
and contour while the patient is in a fingers slightly over each of the five
sitting position. precordial landmarks.
 inspect the skin of the breast for  Auscultate the heart in all five key
localized discolorations or landmarks
hyperpigmentation, retraction or o 5 auscultatory areas
dimpling, localized hyper vascular  Aortic (right- 2nd
areas, swelling or edema intercostal space)
 observe the breast for shape, surface  Pulmonic (left 3rd
characteristics and bilateral pull of intercostal space)
suspensory ligaments. Tell the  Erbs point (left- 4th
patient to raise arm above the head intercostal space)
and with elbows flex and press the  Tricuspid (left- 5th
hands down on the hips. Inspect the intercostal space)
nipples for size, shape, position,  Mitral (left- 6th
color, discharge and lesions <pero intercostal space)
baka di na to pagawa kasi kailanagan
dito expose boobs hahaha>
 palpate the breast, pili ka lang  Begin auscultation using the
isa jan kung pano mo papalpate diaphragm of the stet for
ung breast tas palpate the transmission of high frequency
supraclavicular and sounds listen to several “lob dub”
infraclavicular lymph nodes area cycles in all 5 areas twice. First
tsaka axilliary lymph node identify s1 and s2 then listen for s3
regions and s4 for murmurs and friction.
drop locate aortic valve landmark
and listen for s2 auscultate pulmonic
valve listening for s2 Erbs point
auscultate for murmurs, tricuspid
area assesses for s1 instruct patient
to hold her breath while the client
holds her breath the splitting
disappears neutral bulb assess for s1