U01.16.040 Physical Findings in Select Lung Diseases

This guide summarizes the key physical examination findings associated with various lung diseases, focusing on abnormality in breath sounds, percussion, fremitus, and tracheal deviation.

Overview of Physical Findings

Abnormality	Breath Sounds	Percussion	Fremitus	Tracheal Deviation
Pleural Effusion	Dull, decreased breath sounds	Dull	None if small; increased if large	Away from the side of the lesion
Atelectasis	Dull, decreased breath sounds	Dull	Increased fremitus	Toward the side of the lesion
Simple Pneumothorax	Hyperresonant, decreased breath sounds	Hyperresonant	None	No deviation
Tension Pneumothorax	Hyperresonant, decreased breath sounds	Hyperresonant	None	Away from the side of the lesion
Consolidation (Lobar Pneumonia, Pulmonary Edema)	Bronchial breath sounds, late inspiratory crackles, egophony, whispered pectoriloquy	Dull	Increased fremitus	No deviation

Key Points to Remember

Pleural Effusion:
- Dullness to percussion and decreased breath sounds. The trachea deviates away from the affected side if large.
Atelectasis:
- Dullness and increased fremitus on examination. The trachea deviates toward the affected side.
Pneumothorax:
- Simple pneumothorax shows hyper resonance with no fremitus. Tension pneumothorax results in hyperresonance and tracheal deviation away from the lesion.
Consolidation:
- Increased fremitus and bronchial breath sounds. Dullness on percussion is indicative of consolidation.

Bibliography

Guyton, A. C., & Hall, J. E. (2016). Textbook of Medical Physiology (13th ed.). Elsevier.
Kumar, V., Abbas, A. K., & Aster, J. C. (2015). Robbins and Cotran Pathologic Basis of Disease (9th ed.). Elsevier.
McPherson, R. A., & Pincus, M. R. (2017). Henry’s Clinical Diagnosis and Management by Laboratory Methods (22nd ed.). Elsevier.

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USMLE Step 1 Review Series

Curriculum

U01.16.040 Physical Findings in Select Lung Diseases

Overview of Physical Findings

Key Points to Remember

Bibliography

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