ABSTRACT
Examine this man's respiratory system and give me a differential diagnosis.
Peripheral signs may reveal signs of a possible carcinoma (nicotine staining, clubbing, etc.).
Respiratory rate may be increased (tachypnoea).
Note the central cyanosis (look at the tongue and buccal mucosa).
Diminished chest movement with flattening of the chest wall on the side of the collapse.
Shift in trachea and apex beat of the heart towards the side of the chest flattening gives the clue to diagnosis. Usually the shift of the trachea is seen if the upper lobe of the lung is collapsed, whereas if the lower lobe is collapsed it is the apex beat that is shifted towards the side of the collapse.
Percussion note is impaired over the site of collapse.
Breath sounds are impaired over the site of collapse.
Bronchial breathing and crackles may be present if associated with consolidation.
