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Chest & Breathing Signs

Signs of the chest and breathing: breathing patterns, chest shape and movement, voice sounds heard through the stethoscope, and the emergency signs of respiratory distress in adults and children.

This page lists all 24 of them in the guide. Open any sign for how it is elicited, what it suggests, and its eponym story where it has one.

SignSystemA positive finding is associated with
Barrel chestChest & BreathingAssociated with hyperinflation of the lungs in emphysema and chronic obstructive pulmonary disease.
Biot's breathingChest & BreathingAssociated with raised intracranial pressure and brainstem injury, classically meningitis in the original description.
BronchophonyChest & BreathingAssociated with lung consolidation, as in pneumonia.
Cheyne–Stokes respirationChest & BreathingAssociated with heart failure, stroke and other severe illness affecting the breathing control centres.
D'Espine signChest & BreathingAssociated with enlarged lymph nodes around the bronchi, classically tuberculous nodes in children.
EgophonyChest & BreathingAssociated with consolidation of lung tissue, as in pneumonia, especially above a pleural effusion.
Finger clubbingChest & BreathingAssociated with lung cancer, chronic suppurative lung disease, interstitial lung disease, cyanotic heart disease and some gut and liver conditions.
GruntingChest & BreathingAssociated with significant lung disease in newborns and infants, such as respiratory distress syndrome or pneumonia.
Hamman's signChest & BreathingAssociated with air in the mediastinum (pneumomediastinum), for example after severe vomiting or an asthma attack.
Head bobbingChest & BreathingAssociated with significant respiratory distress in infancy.
Hoover's sign of COPDChest & BreathingAssociated with severe chronic obstructive pulmonary disease (COPD) with a flattened diaphragm.
Increased tactile fremitusChest & BreathingAssociated with consolidation of the underlying lung; fremitus is reduced with pleural effusion or pneumothorax.
Intercostal recessionChest & BreathingAssociated with increased work of breathing and airway obstruction, especially in infants and children.
Kussmaul breathingChest & BreathingAssociated with metabolic acidosis, classically diabetic ketoacidosis.
Litten's phenomenonChest & BreathingReduction is associated with diaphragmatic weakness or paralysis.
Nasal flaringChest & BreathingAssociated with respiratory distress, most often seen in infants and young children.
Oliver's signChest & BreathingAssociated with an aneurysm of the aortic arch sitting close to the trachea.
Paradoxical breathingChest & BreathingAssociated with a flail chest from multiple rib fractures.
Pursed-lip breathingChest & BreathingA compensatory pattern associated with obstructive lung disease, especially COPD and emphysema.
Schamroth's signChest & BreathingA bedside test associated with finger clubbing and its underlying causes.
StridorChest & BreathingAssociated with upper airway obstruction, such as croup, epiglottitis or an inhaled foreign body — an emergency sign in children.
Tracheal deviationChest & BreathingDeviation away from the abnormal side is associated with tension pneumothorax or a large effusion; deviation toward it is associated with lung collapse or fibrosis.
Tripod positionChest & BreathingAssociated with severe breathlessness, classically in COPD exacerbations and severe asthma.
Whispered pectoriloquyChest & BreathingAssociated with lung consolidation, as in pneumonia.
Please note: This page is an educational reference about clinical examination signs. A clinical sign supports — and never replaces — a full clinical evaluation, examination and appropriate testing. A sign being present does not by itself prove a diagnosis, and an absent sign does not rule one out. If you have symptoms that worry you, see a health professional.