Introduction - Pulmonary Examination
This module provides descriptions of techniques for the pulmonary physical examination and data about the accuracy and reliability of findings. A goal of this module is to point out those examination maneuvers that have demonstrated value when assessing patients for likelihood of pneumonia.
Auscultation and percussion are time-honored essential component of the exam and many different maneuvers have been described to detect abnormality of the underlying lung or airways.
There are distinct lung sounds for various lung diseases, confirmed by computerized analyses of lung sounds in normal subjects and in patients with pneumonia, idiopathic pulmonary fibrosis, chronic obstructive lung disease (COPD), and in congestive heart failure (CHF).
Although data is limited, a few studies have assessed the utility of the lung physical examination and inter-observer reliability in predicting pneumonia when compared with chest radiography. The presence of crackles (rales) as a sign of left-ventricular dysfunction and congestive heart failure has been compared with coronary angiography.