Assessing chest expansion by palpation

Now assess the degree and symmetry of expansion by palpation. Again we will ask the patient to take a deep breath. We will assess expansion in two planes:

Firstly, front-to-back (anteroposterior). Place the index finger of one hand over the sternum, the other over the spine. Stand at the side so that you can see and feel how well your fingers move apart.

AFRIKAANS	TRANSCRIPT	XHOSA
	Please take a deep breathe for me. / Haal asseblief diep asem. / Ndicela uphefumle ngamandla.

Having placed the index finger of one hand over the sternum, the other over the spine, ask your patient to take a deep, quiet breath. (He must not jerk or groan or vocalise.) How well do your fingers move apart?

See how this is done.

And now assess expansion from side-to-side (laterally). Place the heel of each hand over the lower ribs laterally on each side. Ask the patient to take a deep breath.

Does the chest expand well? Are left and right sides moving symmetrically?

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Watch the following video clip and comment on:

• The degree of expansion (normal, reduced, absent)
• The symmetry of expansion, whether left moves less well than right, or vice versa, or whether expansion is equal.

AFRIKAANS	TRANSCRIPT	XHOSA
	Can you please take another deep breathe in and out for me. / Asem asseblief weer diep in en uit. / Ndicela uphinde uphefumlele ngaphakathi nangaphandle.