The respiratory excursions can be examined not only through inspection but also by means of palpation. To determine the thoracic excursions five hand positions should be used. Usually these are not routinely carried out but only when inspection raises the suspicion that the thoracic excursions are insufficient or asymmetric. The (relevant) hand positions should then be applied.
Procedure
The 5 hand positions:
In order to determine the thoracic excursions, always place the hands on the thorax on the left– and right-hand side and examine the following locations at easy and deep respiration:
1 upper anterior thorax [Figure 14]
Figure 14: palpapation of the thorax excursions: high at the front of the thorax
2 at the anterior side by following the movements of the costal triangle (the triangle formed by the right and left costal margins) with the thumbs [Figure 15]
Figure 15: palpapation of the thorax excursions: costal triangle
3 on the lateral thorax [Figure 16]
Figure 16: palpapation of the thorax excursions: on the sides
4 with one hand on the sternum and the other on the spine (referred to as the sternal lift) [Figure 17]
Figure 17: palpapation of the thorax excursions: sternal lift
5 low posterior thorax [Figure 18]
Figure 18: palpapation of the thorax excursions: low at the back of the thorax