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👀 General Appearance / Posture
- Patient positioned upright, appears relaxed, and in no acute distress.
- No signs of discomfort or anxiety observed
- Respirations even, symmetrical, within normal rate. Quiet, unlabored,.
- No nasal flaring or use of accessory muscle.
🫁 Thorax Inspection
- Thorax symmetric bilaterally with normal Anterior-Posterior to transverse ratio ≈ 1:2
- Anatomical landmarks identified: suprasternal notch, sternum, manubrium, angle of Louis, 2nd rib, 2nd intercostal spaces, C7 and T1 spinous process
- Vertical reference lines visualized: mid-sternal, mid-clavicular, anterior/mid/posterior axillary lines, and mid-scapular lines, mid-spinal
- Trachea midline; no deviation.
- Skin color consistent with ethnicity, with good hygiene.
- No masses, lumps, or abnormal lesion distribution patterns.
- No deformities (no barrel chest, scoliosis, kyphosis, or pectus abnormalities).
- No lesions, scars, rashes, edema, or abnormal pigmentation.
💅 Nails & 🧴 Skin
- Skin: skin is smooth, intact, warm, and dry.
- Normal mobility and turgor. No lesions, masses.
- Nails: clean, smooth, and firmly attached
- Nail beds pink, with normal shape.
- No clubbing, cyanosis, deformities, or lesions.
- Capillary refill < 3 seconds bilaterally.
✋ Palpation
- Symmetrical chest wall expansion, anterior and posterior.
- Tactile fremitus: vibrations are equal bilaterally (apices → bases, anterior, posterior, lateral).
- No tenderness, crepitus, palpable masses or subcutaneous emphysema.
- Spine midline, no abnormal curvature detected.
🔨 Percussion
- Patient correctly positioned.
- No dullness or hyperresonance detected on anterior, posterior, or lateral lung fields.
🎧 Auscultation
- Breath sounds normal, clear and vesicular bilaterall in all lung lobes.
- No adventitious sounds.
- Normal bronchial, bronchovesicular, and vesicular sounds heard in appropriate locations.