Case 4 – Pneumonia

You are seeing Mrs. Muller, a 45 year old female, in the ER for a new pneumonia. Please examine the patient and comment on his chest X-ray.

Physical Examination


  • Comments on presence of central/peripheral cyanosis (frenulum, lips, fingernails)
  • Inspects for clubbing
  • Comments on respiratory status – tachypnea /intercostal indrawing/accessory muscle use, etc.
  • Examines for thoracic deformities


  • Percusses in all anterior and posterior fields and comments on findings.
  • Uses percussion to estimate diaphragmatic excursion on posterior.


  • Instructs patient to breathe when auscultating
  • States that they would auscultate both lung fields in at least 5 different locations
  • Listens to at least one full breath at each location
  • Auscultates posterior fields, asking patient to cross arms in order to shift scapulae out of lung fields.
  • Comments on of breath sounds and presence of adventitious sounds

Chest X-Ray

  • Comment on abnormality on X-Ray
Case 4 – Pneumonia