PEMERIKSAAN FISIK THORAX

Summary

This video script demonstrates a thorough physical examination procedure for the thorax, focusing on key steps like inspection, palpation, percussion, and auscultation. Conducted by a nursing student from the University of Muhammadiyah Surabaya, it explains the process to identify potential abnormalities in the lungs or heart. The script also outlines how students can use the video as a guide to enhance their practical skills in performing thorax examinations, starting with basic observations and progressing through detailed physical tests, ultimately aiming to assist in diagnosing respiratory or cardiovascular issues.

Takeaways

• 😀 The video demonstrates the step-by-step procedure for performing a thorax physical examination for nursing students.
• 😀 The procedure consists of four main steps: inspection, palpation, percussion, and auscultation.
• 😀 The goal of the thorax examination is to detect abnormalities in the lungs or heart, supporting diagnosis.
• 😀 Patient interaction is essential, with a focus on explaining each part of the examination before proceeding.
• 😀 The examination begins with inspection, where the nurse looks for any visible signs like redness, lesions, or abnormal chest shape.
• 😀 Palpation follows, assessing the symmetry of the chest and detecting any abnormal vibrations during speech (tactile fremitus).
• 😀 Percussion is used to tap on the chest and evaluate sound changes, which indicate the condition of the underlying organs.
• 😀 Auscultation is the final step, where a stethoscope is used to listen for lung and heart sounds, ensuring they are clear and normal.
• 😀 The physical examination is done in a sitting position to ensure comfort and proper access to the chest area.
• 😀 Proper handwashing and maintaining a sterile environment are emphasized throughout the procedure to ensure safety.
• 😀 The script also includes heart examination techniques such as palpation, percussion, and auscultation to evaluate the heart's condition.

Q & A

What is the primary purpose of the physical examination of the thorax as described in the script?

The primary purpose is to assess the condition of the lungs and heart, detect any abnormalities, and support diagnoses. It serves as a guide for nursing students to improve their practical skills in performing thoracic physical examinations.

What are the four main procedures involved in the thoracic physical examination?

The four main procedures are inspection, palpation, percussion, and auscultation.

How is inspection performed during the thoracic examination?

Inspection involves visually checking for any redness, lesions, blueness, and examining the shape and symmetry of the chest. Abnormalities, such as abnormal chest shape or Titus cordis, are also observed.

What is tactile fremitus, and how is it assessed during the examination?

Tactile fremitus is the vibration felt on the chest when the patient speaks. It is assessed by asking the patient to say '77' while palpating the chest at three points to check for normal vibrations.

Why is percussion important in a thoracic examination?

Percussion helps to assess the presence of air in the lungs by tapping on the chest and listening for the sound produced. A normal 'sonorous' sound indicates healthy lung tissue, while other sounds may suggest abnormalities.

What should the examiner listen for during auscultation of the lungs?

During auscultation, the examiner listens for clear lung sounds, checking for the absence of abnormal sounds such as wheezing or crackles. The patient is asked to take a deep breath to assess the quality of breath sounds.

How is the posterior thorax examined differently from the anterior?

The posterior thorax is examined in a similar manner, focusing on inspection for any lesions or color changes, palpation for symmetry, percussion to assess lung sounds, and auscultation to listen to breath sounds in the posterior chest areas.

What is the significance of heart examination in the thoracic procedure?

Heart examination is critical to assess the size and condition of the heart. This includes palpation to locate the heart's borders, percussion to determine the boundaries, and auscultation to listen for heart valve sounds, checking for any abnormal heart rhythms or sounds.

What should be observed during percussion of the heart?

During percussion of the heart, the examiner checks for changes in sound from 'sonorous' to 'dull.' This helps identify the boundaries of the heart, such as the right and left borders, and determines its size and position.

What are the steps to properly conclude the thoracic examination?

The examination concludes by asking the patient if they have any complaints, thanking them for their cooperation, and politely taking leave. The examiner ensures that the patient feels comfortable and informed throughout the process.