hi i'm going to be doing an assessment of your anterior and posterior thorax this will involve me inspecting palpating and auscultating on several areas of your chest is that okay for you yes i will also provide drape throughout the process so right now i'm inspecting the patient for any signs of labor breathing such as use of the trapezius or any use of the neck muscles i'm also inspecting the patient for the lips for any uh any signs of cyanosis i'm also inspecting the color of the skin of the chest uh any use of intercostal muscles um i'm also looking at the way that the patient is breathing and i know that it's normal okay so what i'm gonna do now is i'm in inspecting the anterior posterior ratio and i see that it's one to two which is normal an abnormal finding for the anterior posterior ratio would be two to two which is a sign of barrel chest okay so now i'm gonna be palpating on the anterior of your chest so this will involve me touching areas of your chest is that okay for you yes thank you first thing i'm gonna do is i will sanitize my hands i'm just gonna pop it in chest okay i'm checking for any crepitus any signs of visible masses and i know that there's no uh crepitus okay so i'm also gonna do a palpation i'm gonna check for the expansion of the chest of the thorax so i will be putting my hands like this and i'm going to ask you to take a deep breath one more please so i know that there is equal chest expansion and it's symmetrical and that's a normal finding so what i'm going to ask you to do now is i'm going to be putting my uh the palmer aspect of my hand on several areas of your chest and while i'm doing that i'd like you to say 99 for me please can you please say 99 99 99 99 thank you very much and it is normal tap alfrematis there you go and now i'm going to be auscultating on your thorax so i'll be putting my diaphragm with my stethoscope on several areas of your chest this might take a while but doesn't mean that i'm finding something abnormal i just want to let you know about that and while i'm moving my diet from my stethoscope i'd like you to take a deep breath every time if you ever get dizzy or if you need to take a break please let me know so now i'm gonna clean my stethoscope so now i'm gonna go in the middle here so i know that good good air entry to bases equal bilaterally there is no adventitious sound such as crackles or wheezing and um that is a normal finding so now i'm going to be asking you if you can please move your body so i can inspect an auscultate and palpate your back thank you so i'm also now inspecting the posterior side for any signs of liver breathing and i can see that the patient is sitting up properly uh the patient is not using the intercostal muscles earlier so that's good the patient is breathing normally okay so what i'm gonna do now is i'm gonna be palpating your back i'll be touching your back again is that okay for you thank you so i'm just gonna touch her back okay there's no masses on the posterior side and um that's a normal finding okay so what i'm gonna do now is i'm gonna ask you to take a deep breath while i'm holding your back side here so i'm gonna check for chest expansion one more please i noted symmetrical chest expansion which is normal um so now i'm gonna be um asking you to say 99 again as i move my hands on several areas of your back can you please say 99 99 99 99 99 there's normal tatalframitus okay so now i'm going to be doing an auscultation before i do my auscultation i would landmark the um the loaves of the lungs so is it okay for you to flex your necks your neck please so i am noting the brony prominence here which is the c7 and just inferior to that will be the t1 and that's gonna be my landmark for the apex of the lungs so just across that i'm gonna be listening using the diaphragm of my step you can move up again thank you so much so i'm gonna ask you to take a deep breath whenever i move my stethoscope if you ever get dizzy if you need to take a break please let me know thank you very much did you have any pain while i'm doing my auscultation no so there's no pain on my auscultation uh the patient has clear s so the patient has good air entry to base good area a good air entry to the lungs equal bilaterally there's no advantage of sound such as wheezing or crackles and that's a normal finding for my patient so that concludes my assessment do you have any questions for me before i go no i'm good thank you very much excellent kevin that was very well done your sequencing was correct um i just have a couple of questions when you are listening in the front or the interior chest what would be some areas that you want to avoid so you can listen to the lungs properly thank you very much professor anagil so whenever i'm doing my auscultation something that i should have verbalized is i should not be putting the diaphragm on my stethoscope on the bony areas or the muscular area of the anterior and posterior of the chest because that will impair the sound of the lungs when the patient is breathing excellent great that was very well done thank you very much thank you very much