Lungs Physical Exam Section Medical Transcription Examples

LUNGS: Good breath sounds bilaterally with no wheezes, rales or rhonchi.

LUNGS: Clear. Normal respiratory movements.

LUNGS: Significant for slight expiratory bilateral apical wheezes but no rhonchi or rales appreciated.

LUNGS: The patient had pursed-lipping and arms above head, poor air movement. After one treatment, the patient had good expiratory wheezing and fair movement.

LUNGS: Respirations are unlabored.

LUNGS: Respirations are clear without stridor.

LUNGS: Clear to auscultation bilaterally. No wheezing, rales or rhonchi noted.

LUNGS: The patient has a hoarse cough throughout examination. The patient does have some decreased breath sounds on the right with bilateral wheezing with expiration. The patient has no rales or rhonchi noted.

LUNGS: Clear. She is breathing easily but does have diffuse expiratory wheezes and rhonchi. No focal areas of consolidation but not using accessory muscles to breathe.

LUNGS: Clear to auscultation bilaterally without wheezes, crackles or rhonchi. The patient is breathing easily without retractions or flaring. Normal inspiratory excursion.

LUNGS: Clear with slight expiratory wheeze that is scattered throughout. Deep breath also does send her into coughing. She has a dry hacking cough; however, her lungs clear top to bottom without crackles or rhonchi. No focal areas of consolidation. She is breathing easily without retractions or flaring.

LUNGS/CHEST: Clear to auscultation bilaterally without wheeze, crackles or rhonchi. She is breathing easily without retractions or flaring. Palpation over the left anterior upper chest does give her some significant discomfort, though I do not appreciate any bony step-off or crepitance and certainly no flail component. There is no tenderness over the clavicle. The patient has full range of motion of the left upper extremity but has tenderness to palpation over the right shoulder and is only able abduct to about 30 degrees. She states it is very uncomfortable for her to hold against any resistance.

LUNGS/CHEST: Breath sounds were decreased in both bases. She had some guarding with respirations secondary to her right-sided pleuritic chest pain, even though she had received some morphine.

LUNGS: Her lungs were quite tight, and it is understandable even though her O2 saturation is adequate that she was dyspneic. It was very difficult for her to move air. She had a dry cough, paroxysmal cough and clearly her airway was obstructed.

LUNGS: Showed increased expiratory time and wheezes on forced expiration.

LUNGS: Clear to auscultation, equal breath sounds bilaterally. No wheezes, rales, rhonchi, crackles or stridor noted. Respiratory excursion is symmetrical. No sternal retractions.

LUNGS: Equal expansion and slightly decreased breath sounds.

LUNGS: There is some palpable subcutaneous emphysema on the right.

LUNGS: Clear to auscultation bilaterally. She does have a little bit of diminished inspiratory excursion consistent with COPD, but there are no wheezes, crackles or rhonchi. She is breathing easily without retractions or flaring initially, and then, as noted above, she gets a little bit upset and starts almost hyperventilating, but she maintained oxygen saturations at about 99% on room air the entire stay.

LUNGS/CHEST: Reveal slight crackles to the right, normal rise and fall of the chest wall. The chest wall is tender to palpation along the anterior ribs but no crepitus is felt.

LUNGS: Clear to auscultation in all fields with no evidence of distress.

LUNGS: Showed some anterior lung rhonchi; posteriorly, they were negative.

LUNGS: Scattered wheezing bilaterally.

LUNGS: Reduced breath sounds in the left side. Dullness on percussion. No pleural rub. No expiratory rhonchi.

LUNGS: Reveal significantly decreased breath sounds in the right base and right mid lung field.

LUNGS: CTA bilaterally.

CHEST AND LUNGS: He has some expiratory wheezing and some rhonchi. No obvious rales noted.

LUNGS: Clear. Fair entry. No rales or rhonchi heard.

LUNGS: Have good aeration bilaterally with no wheezing or crackles. There is moderate amount of upper airway congestion with coarseness noted.

LUNGS: Quite clear in examining the anterior and lateral areas. Posterior exam is limited due to the patient’s limited mobility after the surgery. There is no audible wheezing noted. Chest expansion is symmetric. No accessory muscle use. No egophony.

LUNGS: Lung fields at the base were dull to percussion and auscultation bilaterally with left side more dull than right.

LUNGS: Decreased breath sounds bilateral bases. Scattered crepitations. No wheezing.

LUNGS: Significant for mildly decreased breath sounds bilaterally, and the patient does have a slight wheeze, expiratory, with coughing but no audible wheezing otherwise.

LUNGS: Clear to P&A. There is no CVA tenderness or spinal deformity.