Patient Centered Medicine 2
 December 2, 2008

Lung Examination: Abnormals
Arcot Chandrasekhar, M.D.


Lecture: 1:15 p.m., Tobin Hall (190)
Reading Assignment

  1. Bates' Guide to Physical Examination and History Taking, 8th Edition. pp. 212-220, 226-229, 234-243. 9th Edition. pp. 245-251, 258-261, 268-277.
  2. Computer Assisted Lesson
  3. Thaler, Malcom S. The Only EKG Book You'll Ever Need, 4th. ed., 2003,  Chapter 4, pp. 155-190
    5th Edition, 2007, Chapter 4 pp. 155-190
  4. Assignment - Bates Case Study Text, (one book provided to each Small Group), Case Study, Chapter 4: Answer as a group.
    Answer the questions from the assigned Case Study linked here. Come prepared to discuss in Small Group
  1. EKGs - Interpret EKGs 21-24

Key Concepts and Learning Objectives

  1. Describe the relevant anatomy and physiology as pertains to the examination of the lungs.
  2. Correlate pathology to abnormal lung findings.
  3. Recognize abnormalities and patterns of abnormalities as related to various clinical scenarios including; pneumothorax, airway obstruction, (CPD, asthma, chronic bronchitis, etc.), consolidation and lung masses, interstitial lung diseases, left heart failure, and atelectasis pleural effusion.

Required equipment for Small Group: EKG calipers, Earphones for lung sounds

Small Group Session: Immediately following the lecture, Seminar Rooms

Session Objectives Teaching Methods
  1. Identify abnormal physical findings.
  2. Identify abnormal lung sounds using the LUMEN web site.
  3. Interpret rate, rhythm, axis, intervals, hypertrophy, on EKGs provided EKGs 21-24
  4. Visit the LUMEN WEB SITE (steps are listed below) computers in your assigned Seminar Rooms should have speakers
    1. LUMEN
    2. Additional resources
    3.Physical Exam Steps
    4. Links to other web sites
    5. Listen to "Auscultation Assistant" and "Breath Sounds"
  5. Heart and Lung Sounds CD-STETHOGRAPHICS
  1. Brief Q & A of the major concepts learned from the readings and lecture.
  2. Illustration of writing up of abnormal lung findings
  3. Use Heart & Lung Sound CD and LUMEN web site to listen to and identify abnormal lung sounds.
  4. Co-facilitators demonstrate EKG interpretation
  5. Students attempt EKG interpretation
Last Updated: 10/27/08
Created: August 24, 1998