Evaluation of the Pulmonary Patient By Rebecca Dezube, MD, MHS, Johns Hopkins University Reviewed / Revised Jan 2023 View Patient Education History Physical Examination Topic Resources Normal Breath Sounds Normal Bronchial Breath Sounds Crackles Wheezing Stridor Friction Rub E to A Change Finger Clubbing Measuring finger clubbing Key components in the evaluation of patients with pulmonary symptoms are the history, physical examination, and, in many cases, a chest x-ray.