Inspection

The pulmonary examination begins upon meeting the patient. Note evidence of possible underlying pulmonary pathology by observing for:

Clubbing.
Obvious stridor, or wheezing during the interview.
Facial cyanosis or flushing.
Prolongation of the expiratory phase.
Position of the trachea.
Shape of the chest.

Note also the rate of breathing, the depth of breathing, and if breathing is labored. When there is acute respiratory distress, the ability of the patient to talk to you in complete sentences versus short phrases may provide clues as to the severity of the respiratory distress.

Click on the video icon for further discussion of formal inspection, including characteristics of normal and abnormal breathing.