Learning Points

• Determine whether the trachea is deviated
  or central

• Find the cricoid cartilage to determine the
  crico-sternal distance (normal 2cm)

• For the anatomy of the crico-sternal distance, see the next page

• The crico-sternal distance is reduced in patients with a chronically hyperexpanded chest wall (barrel chest)

• "Tracheal Tug"

• Then examine for cervical and axillary lymphadenopathy from behind