Inspection

After a general inspection, the following should be observed:

• respiratory rate and the movement of the diaphragm and chest wall, in normal breathing and with deeper breaths if appropriate.
• chest hyperinflation - specifically an increased anterior-posterior diameter may be noted
• there may be intercostal, subcostal or sternal recession. A long term sequal to this may be Harrison's sulcus.
• nasal flaring may be present
• a tracheal tug is a subtle sign