Respiratory assessment – Overview 

1. Normal Vital Observations (Adult) 


2. Normal Respiratory Assessment  

Use IPPA: Inspection → Palpation → Percussion → Auscultation 

A. General Inspection 
Patient comfortable at rest 
Speaking full sentences 
No respiratory distress 
No cyanosis (central or peripheral) 
No clubbing 
Normal body habitus 

B. Inspection of the Chest 
Symmetrical chest expansion 
Normal chest shape 
No scars, deformities, or chest wall masses 
No use of accessory muscles 
Trachea appears central 

C. Palpation 
Trachea: Central 
Chest expansion: Equal bilaterally 
Chest wall tenderness: Absent 
Vocal fremitus (if done): Symmetrical 

D. Percussion 
Resonant percussion notes throughout lung fields 
No areas of dullness or hyper-resonance 

E. Auscultation 
Breath sounds: Vesicular throughout 
Intensity: Equal bilaterally 
Added sounds: None 
No crackles 
No wheeze 
No stridor 
Vocal resonance: Normal 

3. Normal Respiratory Observations 
Respiratory rate: 12–20 
SpO₂: ≥96% on room air 
No cough or dry occasional cough only 
No sputum production 

4. Example “Normal Findings” Summary 
“On respiratory examination, the patient was comfortable at rest with normal observations. The trachea was central, chest expansion was equal, percussion was resonant throughout, and vesicular breath sounds were heard bilaterally with no added sounds.” 

5. Common Examiner Tips (for physical assessment course/OSCE) 
Always comment on respiratory rate (often missed) 
Look at the patient before touching the chest 
Compare side-to-side 
Don’t forget oxygen saturation 
In OSCEs, always say what you are doing