Inspection of back (in respiratoty system or CVS) is always done in standing position if the condition of the patient permits.This is to avoid undue obliquity.
One should look for the following
- Kyphosis (look from sides in profile).
- Scoliosis.
- Drooping of the shoulder (signifies apical fibrosis or collapse).
- Winging of the scapula (long thoracic nerve palsy or spinal deformity).
- Whether the inferior angle of scapula on both sides are at the same level or not.
- Interscapular area (spino-scapular distance) you should compare between two sides of chest.
- Gibbus is an acute angulation in the spine commonly due to caries spine
- Ankylosing spondylitis (stiff and immobile spine)—may produce restrictive lung disease.
- Crowding of rib is examined both in the front as well as the back.
- Skin condition—Scar, sinus, herpes zoster, local oedema, venous prominence, arterial pulsation(Suzman s sign), pigmentation, deformity after thoracic operation,example thoracoplasty etc.
- Movement—Whether both the sides are moving simultaneously and symmetrically, or not
