The physical examination for a possible lung disease includes a check of breathing rate and pattern and an assessment of how the torso moves during breathing. The way the torso moves is important because some people with lung disease use extra muscles in their abdomen, neck and rib cage to aid in breathing. Also, reduced movement in one side of the chest might suggest disease in the lung on that side. Finally, abnormalities in the structure of the chest could be the cause of breathing difficulty.
In addition, your doctor will use his or her senses of touch and hearing to evaluate the condition. Touching the chest wall may reveal rib fractures or other sources of chest pain. Tapping the chest to generate sound helps the doctor determine how far the diaphragm moves and how much the lungs inflate during breathing. The doctor will also listen to your breath sounds using a stethoscope.
Finally, your doctor can find numerous clues to lung disease simply by looking at you carefully. Examining the hands may reveal discoloration of the nail beds or clubbing of the fingers (a thickening of the fingertips and increased curvature of the fingernails). Blue nail beds suggest low oxygen levels in the blood. Clubbing suggests lung cancer, interstitial lung disease, bronchiectasis, or other problems.
Heart failure can cause difficulty breathing, as can a heart condition known as cor pulmonale, which is caused by high blood pressure in the lungs. Swelling of the legs and feet suggests that a heart problem may be the cause of symptoms. Swelling in one leg suggests a blood clot, which could lead to a pulmonary embolism if it detaches from a vein and travels through the bloodstream to cause a blockage in or around the lungs.