The respiratory physical exam involves four major components: inspection, auscultation, percussion, and palpation. During inspection, the clinician observes the patient's chest movement, symmetry, and any visible abnormalities. Auscultation involves listening to breath sounds with a stethoscope to identify any abnormalities such as wheezing or crackles. Percussion is performed by tapping on the chest to assess underlying structures and detect fluid or air. Finally, palpation is used to feel for abnormalities such as tenderness, masses, or asymmetry in chest expansion.
Commonly, auscultation is the primary method used.
Auscultation involves using the stethoscope to listen to the lungs through the chest. This involves listening to a full respiratory cycle (inhale and exhale) in different parts of the lungs (Mauldin, 2025).
From (Mauldin, 2025).
Colleagues at Stanford Medicine wrote a guide to percussion and inspection, including the value of inspection for signs of COPD. Specific percussion maneuvers are not commonly used in clinical practice.
Pulmonary Exam: Percussion & Inspection
While generally thought of as having more implications for cardiac and renal conditions, being able to assess volume status through the jugular venous pressure (JVP) is an important skill to master. Elevated JVPs can be a sign of heart failure, which can cause shortness of breath. Stanford has a guide on it, below.
Neck Vein Exam | JVP Measurement
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