describe what we see on respiratory physical examination for pleural effusion on each steps

Answer 1

1. Inspection:
- The affected side of the chest may appear to be larger or more swollen compared to the other side.
- There may be asymmetry in chest expansion, with the affected side moving less during respiration.
- Visible signs of respiratory distress, such as increased work of breathing or use of accessory muscles.

2. Palpation:
- Palpation may reveal decreased tactile fremitus (decreased vibrations felt on the chest wall).
- There may be a fluid thrill or a shifting dullness detected on palpation, indicating the presence of fluid in the pleural space.

3. Percussion:
- Dullness to percussion may be present over the area where the pleural effusion is located.
- The level of dullness may change with changes in the patient's position (e.g. becoming more pronounced when the patient is lying on their side).

4. Auscultation:
- Breath sounds may be decreased or absent over the area of the pleural effusion.
- Bronchial breath sounds may be heard over the area with consolidation due to compression of the lung tissue by the effusion.
- Egophony or whispered pectoriloquy may be present over the affected area.

Overall, a combination of findings on inspection, palpation, percussion, and auscultation can help diagnose and assess the severity of pleural effusion on respiratory physical examination.