Chest and lung assessment

Physical assessment of the lungs begins with a careful review of the infant’s history. General inspection begins with overall assessment of the infant’s color, tone, and activity. Asymmetric chest movement is seen in the presence of conditions such as diaphragmatic hernia, cardiac lesions inducing failure, pneumothorax, or phrenic nerve damage. Systematic auscultation of both the anterior and the posterior chest should be performed and one side of the chest compared with the other. The technique for percussion involves placing one finger firmly against the chest wall and tapping that finger with the index finger of the other hand. A change in resonance indicates a change in the consistency of the underlying tissue. After a thorough inspection of the chest, auscultation of breath sounds, and percussion, if necessary, the examiner next palpates certain areas of the infant’s chest. Careful scrutiny of respiratory system is required to identify potential problems for treatment.