Table 16-3.

Classic Physical Findings in Some Common Pulmonary Disorders

Disorder	Inspection	Palpation	Percussion	Auscultation
Bronchial asthma (acute attack)	Hyperinflation; use of accessory muscles	Impaired expansion; decreased fremitus	Hyperresonance; low diaphragm	Prolonged expiration; inspiratory and expiratory wheezes
Pneumothorax (complete)	Lag on affected side	Absent fremitus	Hyperresonant or tympanitic	Absent breath sounds
Pleural effusion (large)	Lag on affected side	Decreased fremitus; trachea and heart shifted away from affected side	Dullness or flatness	Absent breath sounds
Atelectasis (lobar obstruction)	Lag on affected side	Decreased fremitus; trachea and heart shifted toward affected side	Dullness or flatness	Absent breath sounds
Consolidation (pneumonia)	Possible lag or splinting	Increased fremitus on affected side	Dullness	Bronchial breath sounds; bronchophony; pectoriloquy; crackles

Modified from Hinshaw HC, Murray JF, editors: Diseases of the chest, ed 4, Philadelphia, 1980, WB Saunders, p 23.