A doctor first asks the person about symptoms. Chest tightness or pain, shortness of breath (dyspnea Shortness of Breath Shortness of breath—what doctors call dyspnea—is the unpleasant sensation of having difficulty breathing. People experience and describe shortness of breath differently depending on the cause... read more ) either at rest or during exertion, cough, coughing up of sputum or blood Coughing Up Blood Coughing up blood from the respiratory tract is called hemoptysis. The amount of blood produced can vary from a few streaks of blood mixed with normal sputum to large amounts of pure blood.... read more (hemoptysis), and wheezing Wheezing Wheezing is a high-pitched, whistling sound that occurs during breathing when the airways are partially blocked. (See also Wheezing in Infants and Young Children.) Wheezing results from a narrowing... read more may indicate a lung or airway disorder. More general symptoms, such as fever, weakness, fatigue, or a general feeling of illness or discomfort (malaise), sometimes also reflect a lung or airway disorder.
Next, the doctor asks the person about
Past lung disorders and infections
Other current and previous medical problems and treatments
Previous exposure to chemicals, dusts, molds, or animals
Use of drugs, alcohol, and tobacco
Home and work environments
A doctor asks whether family members have had lung or airway disorders or any other disorders that may affect the lungs or airways (such as clotting and generalized inflammatory disorders). The doctor also asks about other common symptoms and other medical disorders, even those that do not seem related to the respiratory system.
During the physical examination, a doctor notes the person's weight and overall appearance. The person's general mood and feeling of well-being, which also may be affected by a lung or airway disorder, are noted. A doctor may ask a person to walk around or climb a flight of stairs to see if either activity causes shortness of breath Shortness of Breath Shortness of breath—what doctors call dyspnea—is the unpleasant sensation of having difficulty breathing. People experience and describe shortness of breath differently depending on the cause... read more . These activities may be done while measuring pulse oximetry, which is a way to quantify the amount of oxygen in the blood. Use of pulse oximetry can allow the doctor to determine if the level of oxygen in the blood is low or if it decreases during exertion.
Assessing skin color is important because a bluish discoloration (cyanosis Cyanosis Cyanosis is a bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood. Cyanosis occurs when oxygen-depleted (deoxygenated) blood, which is bluish rather than... read more ) may indicate an inadequate amount of oxygen in the blood. Fingers are examined for clubbing Recognizing Finger Clubbing Clubbing is enlargement of the tips of the fingers or toes and a change in the angle where the nails emerge. Clubbing occurs when the amount of soft tissue beneath the nail beds increases. It... read more (enlargement of areas around the tips of the fingers).
A doctor observes the chest to determine if the breathing rate and movements are normal. Using a stethoscope, a doctor listens to the breath sounds to determine whether airflow is normal or obstructed, whether the lungs contain fluid, or whether there are any abnormal lung sounds. By tapping (percussing) the chest and/or by feeling how vibrations resulting from speaking are transmitted to the chest wall, a doctor can often determine if the lungs are filled with air or collapsed and if the space around the lungs contains fluid.
In addition to examination of the chest, a complete physical examination may be needed, because disorders of the lungs may affect other parts of the body. Additionally, some symptoms that seem to suggest a lung disorder may be due to a problem elsewhere in the body. For example, shortness of breath Shortness of Breath Shortness of breath—what doctors call dyspnea—is the unpleasant sensation of having difficulty breathing. People experience and describe shortness of breath differently depending on the cause... read more might reflect an abnormality of the kidneys or heart.