Thoracic examination is a general physical examination procedure performed by doctors to determine the condition of the organs in the chest cavity, including the heart and lungs.
The first step that the doctor will take when the patient comes for a check-up is to ask for the complaints they feel, the patient's and family's medical history, the drugs that are being consumed, as well as the patient's daily habits.
Next, the doctor will perform a physical examination, including in the thorax or chest area, to determine the condition of the organs in this section and diagnose the patient's illness.
Stages of Thorax Examination and Estimated Diagnosis
The thorax examination includes four stages, namely observing, feeling, knocking, and listening to the sounds of the heart and lungs with a stethoscope. The following is an explanation of the four stages:
1. Inspection (observation)
At this stage, the examination can be done by looking at the shape and size of the chest, skin color in the chest area, and how to breathe and use the chest muscles.
This examination can assess for abnormalities of the sternum, either concave or protruding, as well as spinal abnormalities. It is also possible to assess the position and use of typical accessory muscles of respiration in asthmatic patients and patients with chronic obstructive pulmonary disease.
2. Palpation (touch)
Palpation is a method of physical examination carried out by doctors by feeling the surface of the body with their hands and fingers. On chest palpation, the doctor will assess the texture, movement, and vibration and airflow of the chest wall.
During this examination, the doctor will feel a difference in texture in the chest area. For example, if the breastbone feels soft, sunken, or protruding, the doctor may suspect a rib fracture. The doctor can also feel a foamy texture on the chest wall, which is known as crepitus. This indicates the presence of air under the skin.
In addition, your doctor may place your palms on your chest and ask you to breathe, count, or say certain words. The goal is to feel the vibrations of the air flow in the lungs.
3. Percussion (beat)
Chest percussion can be performed by the doctor by tapping fingers on a number of areas on the chest or upper back. The sound of this knock can indicate the condition of the organs below.
The knocking sound will be louder and resonant in areas of the body that are filled with air, and will be weaker and fainter in areas of the body that are dense or filled with water. With this examination, lung disorders can be detected, such as pleural effusion and pneumothorax, as well as heart disorders, such as cardiomegaly.
4. Auscultation
Auscultation is an examination method to listen to sounds from inside the body by placing a stethoscope in a certain area. Examination of heart sounds was carried out on the left side of the chest, while examination of lung sounds was carried out on all parts of the chest.
Healthy heart sounds have a regular rhythm, and there are no extra sounds. While in healthy lungs, normal breath sounds will be heard, without wheezing, stridor, or other abnormal breath sounds.
A physical examination of the thorax as described above will assist the doctor in assessing the condition of the organs in the chest cavity, so that the diagnosis can be made. If you are still in doubt or suspect certain conditions, your doctor may recommend further tests, such as a chest X-ray and an electrocardiogram (ECG), to confirm the diagnosis.