Thorax examination is a general physical examination procedure performed by doctors to determine the condition of organs in the chest cavity, including the heart and lungs.
The first step the doctor will take when the patient comes for a check-up is to ask for complaints that are felt, the patient's and family's medical history, medications that are being consumed, and the patient's daily habits.
Next, the doctor will conduct a physical examination, including the thorax or chest area, to determine the condition of the organs in this section and diagnose the patient's illness.
Stages of Thorax Examination and Estimated Diagnosis
Thorax examination involves four stages, namely observing, touching, tapping, and listening to the sound of the heart and lungs with a stethoscope. The following is an explanation of the four stages:
1. Inspection (observation)
At this stage, the examination can be done by looking at the shape and size of the chest, skin color in the chest area, as well as how to breathe and the use of chest muscles.
In this examination, can be assessed for abnormalities of the breastbone, both concave and prominent, and spinal abnormalities. It can also be assessed the position and use of the breathing muscles that are typical in asthma patients and patients with chronic obstructive pulmonary disease.
2. Palpation (touch)
Palpation is a physical examination method performed by doctors by touching the surface of the body with hands and fingers. On chest palpation, the doctor will assess the texture, movement, and vibration and air flow in the chest wall.
In this examination, the doctor will feel the difference in texture in the chest area. For example if the breastbone feels soft, concave, or protruding, the doctor may suspect a rib fracture. The doctor can also feel a foamy texture on the chest wall, known as crepitus. This indicates the presence of air under the skin.
In addition, your doctor may place your palms on the surface of your chest, then ask you to breathe, count, or say certain words. The aim is to feel vibrations from the air flow in the lungs.
3. Percussion (tapping)
Chest percussion can be performed by a doctor by tapping on a number of areas on the surface of the chest or upper back. The sound of this knock can indicate the condition of the organ underneath.
Knocking sounds will be louder and reverberate in parts of the body that contain air, and will be weaker and fainter on parts of the body that are solid or filled with water. With this examination, lung disorders can be detected, such as pleural effusion and pneumothorax, and heart abnormalities, such as cardiomegaly.
4. Auscultation
Auscultation is an examination method for listening to sounds from inside the body by attaching a stethoscope to a certain area. Heart sound checks are performed on the left chest, while lung sound checks are performed on all parts of the chest.
Healthy heart sounds have a regular rhythm, and there are no additional sounds. While in healthy lungs, normal breath sounds will be heard, without wheezing, stridor, or other abnormal breathing sounds.
A physical examination of the thorax as described above will assist the doctor in assessing the condition of the organs in the chest cavity, so that the diagnosis can be made. If you are still in doubt or suspect a certain condition, your doctor may recommend further tests, such as chest X-ray and electrocardiogram (ECG), to confirm the diagnosis.
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