Check for how much the diaphragm moves up and down during breathing
Ask the patient to breathe in, then percuss down the rib cage until dull, ask patient to breathe out, then continue percussing until dull again. The distance between dull sounds is of significance.
Repeat on the other side
Distance between inspiration and expiration should be equal and 4-5cm
Forced Expiratory Time (FET )
Place stethoscope over trachea
Ask the patient to maximally inhale and exhale as quickly as they can with their mouth open.
Listen until maximal inspiration has been achieved. From this point, record the exhalation time until the patient’s airflow is inaudible.
Comment whether it is above or below the normal value of FET < 9s
SOME SPECIAL TESTS FOR CONSOLIDATION
Perform the following special tests for increased suspicion for consolidation, or in an OSCE, mention that you would complete them and your examiner may ask you to move on.
Egophony
Ask patient to say “EEEE” at a normal tone while auscultating
With consolidation, it would sound like “AAAA”
Comment on evidence of consolidation
Whispered Pectoriloquy
Ask patient to whisper “1, 2, 3 ,4” while auscultating
With consolidation, the sound would be amplified and you would be able to hear the whispers.
Comment on evidence of consolidation
Bronchophony
Ask patient to say “toy boat” at a normal tone while auscultating
Stethopedia 