ABSTRACT
The purpose of a physical examination is to elicit signs of a disease. The underlying diagnosis is often evident from thorough history taking, and some visual clues to confirm those suspicions will have been observed while taking the history. Signs can be observed from the moment the patient mobilizes into the room all the way through to how breathless he/she becomes when undressing. Observations such as obesity, cachexia, obvious skeletal deformities, and the smell of cigarette smoke are all instantly apparent even to the most unobservant. Nonetheless, a thorough physical examination of the patient is essential. A working knowledge of the surface markings of themajor structures within the chest is important to aid with the interpretation of signs (Figure 5.1), and a systematic approach to examination should be employed. The four basic tenets of examination are, in order, inspection, palpation, percussion, and auscultation.
