Physical Assessment

	Chief complaint
	Past health, co-exist medical disease, allergy
	Smoking
	Social history
	Exercise tolerance
	Hoarseness of voice
	Weight loss
	Neurological deficit / behaviour change

Examination

Anatomy

- Look for anatomical site of tumour
- Local spread

General

- Ambulation
- Gait
- Mental status
- Speech
- Shortness of breath
- Colour
- Odor: smoking
- Relatives

	Skin
	- Cyanosis, anaemia, clubbing, dermatomyositis
	Head and neck
	- Cervical lymphadenopathy. denture, jaws and neck - SVCO

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Respiratory

- Rate
- Pattern
- Efforts: accessory muscles, pursed-lip breathing
- Stridor
- Chest wall and spine deformity
- Trachea, apex
- Lung expansion
- Percussion: pleural effusion
- Auscultation: wheeze, crepitation

Cardiology

- Ankle edema, xanthalesma
- Heart rate, rhythm
- Heart sound, murmur

	Abdomen
	- Organomegaly - Scars

Investigation

Personnel participated

- Dental surgeons
- Physiotherapists
- Cardiologists / physicians
- Anaesthetists

	General
	- Baseline blood tests: CBP, LRFT - ECG - HBsAg - CXR, old films PA, Lateral, apicolordic, oblique views -Lung functions: astrup, spirometry, diffusion test, ventilation and perfusion scan, stairs walking
	Procedures
	- Bronchoscopy - bronchial brushing - CT scans - Bone scans - ? FNAC - Other: ? PET scans
	Spirometry
	Normal values are based upon age, sex and height, younger, taller have better air volume and flow, and men have slightly higher values than women.....
	FEV1 (forced expiratory volume in first second) FVC (forced vital capacity) Lower limits of lung function for pneumonectomy: FEV1 1.8 FVC 2.8 Predicted postop FEV1 > 0.8
	ABG
	PC0₂ > 45mmHg, contraindication for surgery