Chest excursion, expansion of thorax, rib expansion

DEFINITION:
This procedure evaluates the degree of expansion of the thorax at various levels.

TEST PROCEDURE:
The patient should be seated with an erect posture, not slouching or tilting. Place your fingers and palms symmetrically over the chest wall at a horizontal level so that your thumbs are closely opposing each other or are just touching each other. Another method would be to gather some skin at the mid line. Ask the patient to take a slow deep breath allowing your hands to move with the thorax. Chest the symmetry and extent of expansion of both hands by looking at the movements of the opposing thumbs. Repeat this procedure at the front and back placing the hands over the lower parts of the chest wall where the thorax shows greater expansion.

TEST FINDINGS:
Reduced chest expansion may be caused by poor lung expansion such as in fibrosis, or a pathology affecting the neurological supply to the intercostal muscles. If the lower ribs do not expand also consider pathologies of the diaphragm and associated nerve supply from the phrenic nerve. Also consider spinal conditions such as severe spondylosis, kyphoscoliosis and ankylosing spondylitis.

CONSIDERATIONS:
The results may be influenced by factors such as sitting badly, not taking a full breath, being in pain may produce results which may not be representative of the real ability to expand the thorax.

(Full details and demonstration of the procedure is provided with the DVD/videos and associated study material)