Check list for assessment of cough in chest cases :
YES NO
1 mark for each 0 mark for each
Ask about onset . Acute
. Sub Acute
. Chronic
Ask about course . Progressive
. Regressive
Ask about duration . Short duration
. Long duration
Ask about character . Wheezy
. Bovine with hoarseneds
. Parking with hoarseness
and stridor
Ask about timing and associated features . Nocturnal
. Early morning
. Recumbent
. Change position
(standing)
Ask about if cough is with or without . Dry cough
sputum
. Productive cough
Ask about if it is with or without blood . Hemoptysis ( with
blood)
. No haemoptysis
(without blood)
Ask about if there is any associated . If there is fever or not
symptoms as fever , shortness of breath
. If there is shortness of
or chest pain
breath or not
. If there is chest pain or
not
Total marks………………..
dyspnea Yes 1 mark No 0 mark
Ask about Onset Acute – subacute - choronic
Ask about Coarse Progressive – stationary -
regressive
Ask about Duration For what time hours days
months or years
Number 0f Grade From 0 to 4 according to
mMRC dyspnea scale
What increase Exercise – dust -cold -------
What decrease Rest – treatment -avoid
exposure -------
With orthopnea ? or not If there is or not
With PND ? or not If there is or not
With wheeze ?or not If there is or not
Ask about Effect of Has reliver effect or not
treatment
Ask about Date of last attack Date
Ask about Diurnal variation If there is or not
Ask about Seasonal If there is or not
variation
Total degree
Chest pain Yes No
assessment 0 mark for each
1 mark for each
Ask about onset Acute, sub-acute or
chronic
Ask about Progressive,
regressive or
Course
stationary
Ask about Time in hours, days,
months or years
duration
Ask about site of Localized to special
site or diffuse
pain
Ask about Sharp, stabbing,
burning,
character of pain
compressing or dull
aching
Ask about Radiated or not
radiation of pain
Ask if Referred Referred or not
or not
Ask about What Exertion, cough
,breathing,…
bring pain
Ask about What Rest, hold of
breathing, special
relieve pain
position,…
Total marks
Check list for assessment of personal history taking :
YES NO
1 mark for each 0 mark for each
Introducing him\herself to the patient
Taking permission from the patient for getting
some information from him
Mention full name of the pt
Mention pt sex
Mention pt age
Mention pt occupation
Mention pt address
Mention pt marital status
Mention pt special habits including smoking ,
alcoholism and addiction
Total marks
Present history
Yes 1 mark No 0 mark
Analysis of complaint Onset – course – duration
Association with
What increase
Date of complaint
Ask about Cough Association with wheeze
Horseness
Vomiting
Diurnal variation
Character
Ask about Expectoration
Type Type mucoid – purulent- rusty
Black – chocolate
Amount Amount >1cup
Odour Has bad odour or not
Postural variation Increase in special posture or
not
Ask about Haemoptysis
Type Type frothy
Blood staind
Rusty
Frank
Amount Amount small or large amount
Ask about Dyspnae
Type Type exertional- paroxysmal –
postural- at rest
Onset Onset acute -subacute –
Coarse chronic
Duration Coarse progressive – stationary
Grade Duration days months years
From 0 - 4
Ask about Orthpnea There is or not
Ask about PND There is or not
Ask about Wheeze Continuous or paroxysmal
Ask about Toxic symptoms
fever There is or not
Sweating
Anorexia
Loss of weight
Ask about Chest pain Localized or diffuse
Characterized by stitching-dull
aching – stabing- throbbing –
tearing
Increased by
Relived by
Ask about DM Pt diabetic or not
Ask about hypertention Pt hypertensive or not
Total degree
Past history Yes No
assessment 1 mark for each 0 mark for each
Ask about history of similar
condition
Ask about history of T.B.
Ask about history of bl.
transfusion
Ask about history of hospital
admission
Ask about history of travelling
abroad
Ask about history of drug
allergy
Ask about history of trauma
Ask about history of surgical
operation
Total marks
Local chest examination:
inspection Yes No
1 mark for each 0 mark for each
Identify normal
Shape of the chest
Identify normal
exansion or
movement of the
chest
Identify pulsations
that may be visible
on chest inspection
Identify any Chest
wall swellings or
lesions
Palpation Yes No
Able to do
Confirmation of chest
movement
Identify any Palpable
rhonchi or
crepitations
Recognize T.V.F
Know normal site of
Trachea
Confirm pulsations
Percussion Yes No
Able to compare
note of percussion of
intercostal spaces
Localize level of
Upper border of liver
Localize Bare area of
the heart
Know boundaries of
Kronig's isthmus
Auscultation Yes No
Specify Intensity of
breath sounds
Recognize Types of
breath sounds
Know Adventitious
sounds
Total marks
Local chest examination:
inspection Yes No
1 mark for each 0 mark for each
Identify normal -Symmetrical
Shape of the -Antero-posterior
diameter : transverse
chest diameter =5:7
-subcostal angle = about
90
Identify normal -Equal expansion
on both sides. Or
expansion or -restricted
movement of the expansion on one
chest side.
Identify -Epigastric pulsation
pulsations that Apical pulsation-
may be visible on -Rt & Lt 2nd intercostal
space pulsation
chest inspection
Lt parasternal pulsation-
Identify any Chest -subcutaneous
wall swellings or emphysema,
subcutaneous sarcoid
lesions nodules, bony swelling
of ribs or spine
-skin eruption e.g.
purpuric spots or herpes
zoster.
Engorged veins on chest
wall.
Total marks
Palpation Yes No
1 mark for each 0 mark for each
Able to do -equal expansion or
restricted on one side.
Confirmation of
chest movement
Identify any -there is palpable ronchi
or not
Palpable rhonchi
or crepitations
Recognize T.V.F -increase or decrease
T.V.F.
Know normal site Central or shifted
trachea to one side.
of Trachea
Confirm -Epigastric pulsation
Apical pulsation-
pulsations -Rt & Lt 2nd intercostal
space pulsation
Lt parasternal pulsation
Total marks
Percussion Yes No
1 mark for each mark for each 0
Able to compare -resonant -
hyperresonant -
note of impaired note - dullness
percussion of -stony dullness
intercostal spaces
Localize level of -5th Rt intercostal space
Upper border of
liver
Localize Bare area -Lt parasternal 4th and
5th intercostal space
of the heart
Know boundaries -Laterally it's marked by
a line joining 2 points:
of Kronig's
1-the junction of the
isthmus medial 2/3 of the
clavicle with the lateral
1/3.
2-the junction of the
medial 1/3 of the
scapular pine with the
lateral 2/3.
-Medially marked by a
line between the sternal
end of the clavicle and
the 7th cervical spine.
Total marks
Auscultation Yes No
1 mark for each 0 mark for each
Specify Intensity -equal air entry
of breath sounds -decrease on one side
Recognize Types -normal vesicular
breathing
of breath sounds
-bronchial breathing
-vesicular breathing
with prolonged
expiration
Know -Rhonchi - Crepitations -
Adventitious Pleural rub
sounds
Total marks
