Chest Topography

Thorax is relatively large space containing many organs and anatomical structures. An ability to precisely pinpoint specific area is important in physical examination, diagnosis and writing clinical notes.

Examination of Neck Veins – Venous Pressure

Inspection of neck veins is an important part of cardiopulmonary examination. Physician should examine neck veins for two reasons: first, to estimate venous pressure and second, to detect venous waveform abnormalities. Skillful bedside examination estimates pressure abnormalities accurately compared to measured values.

Lung Auscultation – Adventitious Breath Sounds

Adventitious breath sounds are abnormal sounds heard during the auscultation. That represents all the sounds other than normal breath sounds or vocal resonance. Their nomenclature is very ambiguous and confusing and vary greatly from physician to physician. This can lead to misinterpretation and possibly medical errors. Clear and united nomenclature is therefore of great importance.

Lung Auscultation – Normal Breath Sounds

Despite the advancements in chest investigation methods, auscultation remains the fundamental part of the physical examination. There is no other more readily available and cost-effective diagnostic method that can be repeated as often as necessary. Modern stethoscopes convey sounds better than ever, however, their usefulness still depends on the part between the earpieces.


Percussion is one of the fundamental examination techniques, along with inspection, palpation and auscultation. After more than two centuries of its use in modern medicine it still has invaluable place in diagnosis of chest disorders, pleural effusion in particular. The main goal is to generate percussion sound that is specific for surrounding tissues, detecting disease, in other times to elicit pain.